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Sigmoid Resection

Updated: Dec 4, 2020

These images are from a sigmoid resection. The remaining colon was normal. What is your diagnosis?

Answer – Diverticular disease-associated colitis.

Comment - Sometimes diverticular disease-associated colitis is a perfect mimic of Crohn's disease. In this example, there are granulomas and even giant cell arteritis but the process is restricted to the sigmoid colon. In a classic study by Goldstein and his colleagues, most patients never manifested Crohn's disease (but a small subset did).

Ref: Goldstein NS, Leon-Armin C, Mani A. Crohn's colitis-like changes in sigmoid diverticulitis specimens is usually an idiosyncratic inflammatory response to the diverticulosis rather than Crohn's colitis. Am J Surg Pathol. 2000 May;24(5):668-75. PMID: 10800985.

This case is provided by Dr. Elizabeth Montgomery. Her survival guides to GI Biopsies and Soft Tissue will soon be out of stock!

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