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Diverticular colitis is a segmental colitis, developing most commonly in the sigmoid colon of patients with diverticula. Its endoscopic features resemble ulcerative colitis or Crohn's disease, but by definition it does not involve the rectum. It is unknown if diverticular colitis is related to diverticula or inflammatory bowel disease.
A 75-year-old male, who had previously undergone yearly follow-up colonoscopy to monitor adenoma and nonspecific inflammation without subjective symptoms, presented with lower abdominal pain and tenderness. Abdominal computed tomography (CT) revealed multiple diverticula and segmental inflammation involving the transverse and sigmoid colon. Colonoscopy showed stenosis near the splenic flexure, and segmental inflammation of the mucosa. The rectum was not involved. The case was diagnosed as diverticular colitis.
The patient did not respond to antibiotics ; therefore, mesalazine therapy was initiated. Although abdominal pain resolved, laboratory results and CT findings worsened. Corticosteroids were added to the treatment regimen and follow up is ongoing.
