Sigmoid colon stenosis by diverticulitis-derived abscess formation in patient with ulcerative colitis -a case report-

Abstract

The complication of diverticulitis in the patients with ulcerative colitis (UC) is rare, because UC is common in young people and diverticulosis in elderly people. Here we presented a rare case of UC with sigmoid colon stenosis due to the abscess derived from diverticulitis.

70-year-old male with 2-year history of ulcerative colitis (UC) treated with 5-aminosalycilic acid (5-ASA) admitted to our hospital due to the recurrence after one-year remission. Blood examination demonstrated elevated white blood cell (WBC) and CRP. Contrast-enhanced computed tomography (CT) demonstrated abscess formation around sigmoid colon with multiple diverticulosis, and thickening of colonic wall from sigmoid colon to rectum. Colonoscopy demonstrated recurrence of UC and sigmoid colon stenosis. Prednisolone improved mucosal inflammation, however, did not improve stenosis and abscess formation. Therefore, sigmiodectomy was performed and resected specimen presented sigmoid colon stenosis with diverticulitis with the infiltration of neutrophils. Differential diagnosis may include superimpose of diverticular colitis in the setting of UC.

Diverticulitis should be considered as differential diagnosis when segmental stenosis was complicated in elderly patients with UC.