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Chapter 26 - Diverticular Disease, Mucosal Prolapse, and Related Conditions

Published online by Cambridge University Press:  06 June 2020

By
Lukasz A. Adamczyk  and
Neil A. Shepherd
Edited by
Roger M. Feakins
Roger M. Feakins
Affiliation:
Royal Free London NHS Foundation Trust, London, UK
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Summary

Diverticular disease of the sigmoid colon is one of the most common diseases at sigmoidoscopy/colonoscopy and yet biopsies are not often taken from the colon afflicted by this disease. Indeed, biopsies are often contraindicated in acute diverticulitis because of the risks of perforation. Nevertheless, there is increasing understanding that the disease is associated with luminal mucosal pathology, namely diverticular colitis, which is a close histological mimic of chronic inflammatory bowel disease (IBD). Indeed, there is a close relationship between the diseases and there are occasional cases where diverticular colitis is followed, in due course, by the onset of true chronic IBD, specifically ulcerative colitis. The disease is also associated with characteristic mucosal polypoid change. Often mucosal biopsies show similar inflammatory changes to those seen in classical diverticular colitis but the pathology of mucosal prolapse may also be seen. The latter features may occur in many different situations, although all show the same characteristic morphological appearances. Such situations include stomas, both ileal and colonic, in association with ‘cap polyposis’, in solitary ulcer (mucosal prolapse) syndrome in the rectum, and at the anorectal junction in so-called inflammatory cloacogenic polyp. Several other conditions can produce mimicry of chronic IBD in mucosal biopsies, having in common the ability to produce underlying mass lesions that result in ‘secondary colitis’ in the mucosa. These conditions include endometriosis, pneumatosis coli, primary and secondary tumours, and inevitably, intramural and extramural suppuration associated with diverticular disease itself.

Keywords

diverticulosisrectal prolapsepneumatosis cystoides intestinalisinflammatory bowel diseaseendometriosis
Type
Chapter
Information
Non-Neoplastic Pathology of the Gastrointestinal Tract
A Practical Guide to Biopsy Diagnosis
 , pp. 417 - 433
Publisher: Cambridge University Press
Print publication year: 2020

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References

Stollman, N, Raskin, JB. Diverticular disease of the colon. Lancet. 2004;363:631–9.Google Scholar
Humes, DJ, Ludvigsson, JF, Jarvholm, B. Smoking and the risk of hospitalization for symptomatic diverticular disease. Dis Colon Rectum. 2016;59:110–14.Google Scholar
Warner, E, Crighton, EJ, Moineddin, R, et al. Fourteen-year study of hospital admissions for diverticular disease in Ontario. Can J Gastroenterol. 2007;21:97–9.Google Scholar
Painter, NS, Burkitt, DP. Diverticular disease of the colon: a deficiency disease of Western civilization. Br Med J. 1971;2:450–4.Google Scholar
Segal, I, Leibowitz, B. The distributional pattern of diverticular disease. Dis Colon Rectum. 1989;32:227–9.Google Scholar
Kang, JY, Hoare, J, Tinto, A, et al. Diverticular disease of the colon-on the rise: a study of hospital admissions in England between 1989/1990 and 1999/2000. Aliment Pharmacol Ther. 2003;17:1189–95.Google Scholar
Schauer, PR, Ramos, R, Ghiatas, AA, Sirinek, KR. Virulent diverticular disease in young obese men. Am J Surg. 1992;164:443–8.Google Scholar
Manousos, O, Day, NE, Trichopoulos, D, Gerovassilis, F, Tzonou, A, Polychronopoulou, A. Diet and colorectal cancer: a case-control study in Greece. Int J Cancer. 1983;32:1–5.Google Scholar
Weizman, AV, Nguyen, GC. Diverticular disease: epidemiology and management. Can J Gastroenterol. 2011;25:385–9.Google Scholar
Hughes, LE. Postmortem survey of diverticular disease of the colon. I. Diverticulosis and diverticulitis. Gut. 1969;10:336–44.Google ScholarPubMed
Tănase, I, Păun, S, Stoica, B, Negoi, I, Gaspar, B, Beuran, M. Epidemiology of diverticular disease – systematic review of the literature. Chirurgia. 2015;110:9–14.Google Scholar
Shahedi, K, Fuller, G, Bolus, R, et al. Long-term risk of acute diverticulitis among patients with incidental diverticulosis found during colonoscopy. Clin Gastroenterol Hepatol. 2013;11:1609–13.Google Scholar
Painter, NS, Burkitt, DP. Diverticular disease of the colon, a 20th century problem. Clin Gastroenterol. 1975;4:3–21.Google Scholar
Delvaux, M. Diverticular disease of the colon in Europe: epidemiology, impact on citizen health and prevention. Aliment Pharmacol Ther.2003;18(Suppl 3):71–4.Google Scholar
Walker, AR, Segal, I. Epidemiology of noninfective intestinal diseases in various ethnic groups in South Africa. Isr J Med Sci. 1979;15:309–13.Google Scholar
Lee, YS. Diverticular disease of the large bowel in Singapore: an autopsy survey. Dis Colon Rectum. 1986;29:330–5.Google Scholar
Azzam, N, Aljebreen, AM, Alharbi, O, Almadi, MA. Prevalence and clinical features of colonic diverticulosis in a Middle Eastern population. World J Gastrointest Endosc. 2013;5:391–7.Google Scholar
Hjern, F, Johansson, C, Mellgren, A, Baxter, NN, Hjern, A. Diverticular disease and migration: the influence of acculturation to a Western lifestyle on diverticular disease. Aliment Pharmacol Ther. 2006;23:797–805.Google Scholar
Levy, N, Stermer, E, Simon, J. The changing epidemiology of diverticular disease in Israel. Dis Colon Rectum. 1985;28:416–8.Google Scholar
Sugihara, K, Muto, T, Morioka, Y. Motility study in right-sided diverticular disease of the colon. Gut. 1983;24:1130–4.CrossRefGoogle ScholarPubMed
Markham, NI, Li, AK. Diverticulitis of the right colon: experience from Hong Kong. Gut. 1992;33:547–9.Google Scholar
Ngoi, SS, Chia, J, Goh, MY, Sim, E, Rauff, A. Surgical management of right colon diverticulitis. Dis Colon Rectum. 1992;35:799–802.Google Scholar
Nakaji, S, Danjo, K, Munakata, A, et al. Comparison of etiology of right-sided diverticula in Japan with that of left-sided diverticula in the West. Int J Colorectal Dis. 2002;17:365–73.Google Scholar
AbdullGaffar, B. Diverticulosis and diverticulitis of the appendix. Int J Surg Pathol. 2009;17:231–7.Google Scholar
Lipton, S, Estrin, J, Glasser, I. Diverticular disease of the appendix. Surg Gynecol Obstet. 1989;168:13–16.Google ScholarPubMed
Kabiri, H, Clarke, LE, Tzarnas, CD. Appendiceal diverticulitis. Am Surg. 2006;72:221–3.Google ScholarPubMed
Dupre, MP, Jadavji, I, Matshes, E, Urbanski, SJ. Diverticular disease of the vermiform appendix: a diagnostic clue to underlying appendiceal neoplasm. Hum Pathol. 2008;39:1823–6.Google Scholar
Wetzig, NR. Diverticulosis of the vermiform appendix. Med J Aust. 1986;145:464–5.Google Scholar
Al-Brahim, N, Al-Kandari, I, Munahai, M, Sharma, P. Clinicopathological study of 25 cases of diverticular disease of the appendix: experience from Farwaniya Hospital. PatholRes Int. 2013;404308 (epub).Google Scholar
Hsu, M, Young, RH, Misdraji, J. Ruptured appendiceal diverticula mimicking low-grade appendiceal mucinous neoplasms. Am J Surg Pathol. 2009;33:1515–21.Google Scholar
du Boulay, CE, Fairbrother, J, Isaacson, PG. Mucosal prolapse syndrome: a unifying concept for solitary ulcer syndrome and related disorders. J Clin Pathol. 1983;36:1264–8.Google Scholar
Gore, S, Shepherd, NA, Wilkinson, SP. Endoscopic crescentic fold disease of the sigmoid colon: the clinical and histopathological spectrum of a distinctive endoscopic appearance. Int J Colorectal Dis. 1992;7:76–81.Google Scholar
Kelly, JK. Polypoid prolapsing mucosal folds in diverticular disease. Am J Surg Pathol. 1991;15:871–8.Google Scholar
Ludeman, L, Shepherd, NA. What is diverticular colitis? Pathology. 2002;34:568–72.Google Scholar
Shepherd, NA. Diverticular disease and chronic idiopathic inflammatory bowel disease: associations and masquerades. Gut. 1996;38:801–2.Google Scholar
Schmidt, GT, Lennard-Jones, JE, Morson, BC, Young, AC. Crohn’s disease of the colon and its distinction from diverticulitis. Gut. 1968;9:7–16.Google Scholar
McCue, J, Coppen, MJ, Rasbridge, SA, Lock, MR. Coexistent Crohn’s disease and sigmoid diverticulosis. Postgrad Med J. 1989;65:636–9.Google Scholar
Simpson, J, Scholefield, JH, Spiller, RC. Pathogenesis of colonic diverticula. Br J Surg. 2002;89:546–54.Google Scholar
Beighton, PH, Murdoch, JL, Votteler, T. Gastrointestinal complications of the Ehlers-Danlos syndrome. Gut. 1969;10:1004–8.Google Scholar
Whiteway, J, Morson, BC. Elastosis in diverticular disease of the sigmoid colon. Gut. 1985;26:258–66.Google Scholar
Golder, M, Burleigh, DE, Ghali, L, et al. Longitudinal muscle shows abnormal relaxation responses to nitric oxide and contains altered levels of NOS1 and elastin in uncomplicated diverticular disease. Colorectal Dis. 2007;9:218–28.Google Scholar
Painter, NS, Truelove, SC. The intraluminal pressure patterns in diverticulosis of the colon. 3. The effect of prostigmine. IV. The effect of pethidine and probanthine. Gut. 1964;5:365–73.Google Scholar
Costedio, MM, Coates, MD, Danielson, AB, et al. Serotonin signaling in diverticular disease. J Gastrointest Surg. 2008;12:1439–45.Google Scholar
Domizio, P, Martin, JE. Neuromuscular and mechanical disorders of the large intestine. In Shepherd, NA, Warren, BF, Williams, GT, Greenson, JK, Lauwers, GY, Novelli, MR (eds), Morson and Dawson’s Gastrointestinal Pathology, 5th ed. Oxford: Blackwell; 2013, 531–51.Google Scholar
Slack, WW. Bowel muscle in diverticular disease. Gut. 1966;7:668–70.Google Scholar
Thomson, HJ, Busuttil, A, Eastwood, MA, Smith, AN, Elton, RA. Submucosal collagen changes in the normal colon and in diverticular disease. Int J Colorectal Dis. 1987;2:208–13.Google Scholar
Wess, L, Eastwood, MA, Wess, TJ, Busuttil, A, Miller, A. Cross linking of collagen is increased in colonic diverticulosis. Gut. 1995;37:91–4.Google Scholar
Ford, MJ, Camilleri, M, Wiste, JA, Hanson, RB. Differences in colonic tone and phasic response to a meal in the transverse and sigmoid human colon. Gut. 1995;37:264–9.CrossRefGoogle ScholarPubMed
Peery, AF, Sandler, RS. Diverticular disease: reconsidering conventional wisdom. Clin Gastroenterol Hepatol. 2013;11:1532–7.Google Scholar
Strate, LL. Diverticulosis and dietary fiber: rethinking the relationship. Gastroenterology. 2012;142:205–7.Google Scholar
Ornstein, MH, Littlewood, ER, Baird, IM, Fowler, J, North, WR, Cox, AG. Are fibre supplements really necessary in diverticular disease of the colon? A controlled clinical trial. Br Med J. 1981;282:1353–6.Google Scholar
Pan, GZ, Liu, TH, Chen, MZ, Chang, HC. Diverticular disease of colon in China: A 60-year retrospective study. Chin Med J (Engl). 1984;97:391–4.Google Scholar
Aldoori, WH, Giovannucci, EL, Rockett, HR, Sampson, L, Rimm, EB, Willett, WC. A prospective study of dietary fiber types and symptomatic diverticular disease in men. J Nutr. 1998;128:714–9.Google Scholar
Gear, JS, Ware, A, Fursdon, P, et al. Symptomless diverticular disease and intake of dietary fibre. Lancet. 1979;1:511–14.Google Scholar
Crowe, FL, Appleby, PN, Allen, NE, Key, TJ. Diet and risk of diverticular disease in Oxford cohort of European Prospective Investigation into Cancer and Nutrition (EPIC): prospective study of British vegetarians and non-vegetarians. BMJ. 2011;343: d4131.Google Scholar
Strate, LL, Modi, R, Cohen, E, Spiegel, BMR. Diverticular disease as a chronic illness: evolving epidemiologic and clinical insights. Am J Gastroenterol. 2012;107:1486–93.CrossRefGoogle ScholarPubMed
Freischlag, J, Bennion, RS, Thompson, JE. Complications of diverticular disease of the colon in young people. Dis Colon Rectum. 1986;29:639–43.Google Scholar
Acosta, JA, Grebenc, ML, Doberneck, RC, McCarthy, JD, Fry, DE. Colonic diverticular disease in patients 40 years old or younger. Am Surg. 1992;58:605–7.Google Scholar
Nagorney, DM, Adson, MA, Pemberton, JH. Sigmoid diverticulitis with perforation and generalized peritonitis. Dis Colon Rectum. 1985;28:71–5.Google Scholar
Bahadursingh, AM, Virgo, KS, Kaminski, DL, Longo, WE. Spectrum of disease and outcome of complicated diverticular disease. Am J Surg. 2003;186:696–701.Google Scholar
Woods, RJ, Lavery, IC, Fazio, VW, Jagelman, DG, Weakley, FL. Internal fistulas in diverticular disease. Dis Colon Rectum. 1988;31:591–6.Google Scholar
Colcock, BP, Stahmann, FD. Fistulas complicating diverticular disease of the sigmoid colon. Ann Surg. 1972;175:838–46.Google Scholar
Sheth, AA, Longo, W, Floch, MH. Diverticular disease and diverticulitis. Am J Gastroenterol. 2008;103:1550–6.Google Scholar
Burroughs, SH, Bowrey, DJ, Morris-Stiff, GJ, Williams, GT. Granulomatous inflammation in sigmoid diverticulitis: two diseases or one? Histopathology. 1998;33:349–53.Google Scholar
Meyers, MA, Alonso, DR, Morson, BC, Bartram, C. Pathogenesis of diverticulitis complicating granulomatous colitis. Gastroenterology. 1978;74:24–31.Google Scholar
Ludeman, L, Warren, BF, Shepherd, NA. The pathology of diverticular disease. Best Pract Res Clin Gastroenterol. 2002;16:543–62.Google Scholar
Strate, LL, Liu, YL, Aldoori, WH, Syngal, S, Giovannucci, EL. Obesity increases the risks of diverticulitis and diverticular bleeding. Gastroenterology. 2009;136:115–122.Google Scholar
Aune, D, Chan, DSM, Lau, R, et al. Dietary fibre, whole grains, and risk of colorectal cancer: systematic review and dose-response meta-analysis of prospective studies. BMJ. 2011;343: d6617.Google Scholar
Cawthorn, SJ, Gibbs, NM, Marks, C. Segmental colitis: a new complication of diverticular disease. Gut. 1983;24: A500.Google Scholar
Jain, D, Warren, BF, Riddell, RH. Inflammatory disorders of the large intestine>. In Shepherd, NA, Warren, BF, Williams, GT, Greenson, JK, Lauwers, GY, Novelli, MR (eds), Morson and Dawson’s Gastrointestinal Pathology, 5th ed. Oxford: Blackwell; 2013, 552–635.Google Scholar
Makapugay, LM, Dean, PJ. Diverticular disease-associated chronic colitis. Am J Surg Pathol. 1996;20:94–102.Google Scholar
Tursi, A. Segmental colitis associated with diverticulosis: complication of diverticular disease or autonomous entity? Dig Dis Sci. 2011;56:27–34.Google Scholar
Imperiali, G, Terpin, M, Meucci, G, Ferrara, A, Minoli, G. Segmental colitis associated with diverticula: a seven year follow-up study. Endoscopy. 2006;38:610–2.Google Scholar
Koutroubakis, IE, Antoniou, P, Tzardi, M, Kouroumalis, EA. The spectrum of segmental colitis associated with diverticulosis. Int J Colorectal Dis. 2005;20:28–32.Google Scholar
Gupta, J, Shepherd, NA. Colorectal mass lesions masquerading as chronic inflammatory bowel disease on mucosal biopsy. Histopathology. 2003;42:476–81.Google Scholar
Hassan, C, Zullo, A, Ierardi, E, Burattini, O, De Francesco, V, Morini, S. Tumour necrosis factor down-regulation and therapeutic response to infliximab in a case of segmental colitis associated with diverticula. Gut. 2006;55:589–90.Google Scholar
Shepherd, NA. Pathological mimics of chronic inflammatory bowel disease. J Clin Pathol. 1991;44:726–33.Google Scholar
Jani, N, Finkelstein, S, Blumberg, D, Regueiro, M. Segmental colitis associated with diverticulosis. Dig Dis Sci. 2002;47:1175–81.CrossRefGoogle ScholarPubMed
Peppercorn, MA. Drug-responsive chronic segmental colitis associated with diverticula: a clinical syndrome in the elderly. Am J Gastroenterol. 1992;87:609–12.Google Scholar
Berman, IR, Corman, ML, Coller, JA, Veidenheimer, MC. Late onset Crohn’s disease in patients with colonic diverticulitis. Dis Colon Rectum. 1979;22:524–9.Google Scholar
Sultan, K, Fields, S, Panagopoulos, G, Korelitz, BI. The nature of inflammatory bowel disease in patients with coexistent colonic diverticulosis. J Clin Gastroenterol. 2006;40:317–21.Google Scholar
Mulhall, AM, Mahid, SS, Petras, RE, Galandiuk, S. Diverticular disease associated with inflammatory bowel disease-like colitis. Dis Colon Rectum. 2009;52:1072–9.Google Scholar
Lamps, LW, Knapple, WL. Diverticular disease-associated segmental colitis. Clin Gastroenterol Hepatol. 2007;5:27–31.Google Scholar
Pereira, MC. Diverticular disease-associated colitis: progression to severe chronic ulcerative colitis after sigmoid surgery. Gastrointest Endosc. 1998;48:520–3.Google Scholar
Maeshiro, T, Hokama, A, Kinjo, T, Fujita, J. Diverticular colitis of the ascending colon preceding the onset of ulcerative colitis. BMJ Case Rep.2014; DOI:10.1136/bcr-2014-204361 (epub).Google Scholar
Joo, M, Odze, RD. Rectal sparing and skip lesions in ulcerative colitis: a comparative study of endoscopic and histologic findings in patients who underwent proctocolectomy. Am J Surg Pathol. 2010;34:689–96.Google Scholar
Warren, BF, Shepherd, NA. Diversion proctocolitis. Histopathology. 1992;21:91–3.Google Scholar
Davison, AM, Dixon, MF. The appendix as a ‘skip lesion’ in ulcerative colitis. Histopathology. 1990;16:93–5.Google Scholar
Gledhill, A, Dixon, MF. Crohn’s-like reaction in diverticular disease. Gut. 1998;42:392–5.Google Scholar
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;24:668–75.Google Scholar
Graham, DM, Appelman, HD. Crohn’s-like lymphoid reaction and colorectal carcinoma: a potential histologic prognosticator. Mod Pathol. 1990;3:332–5.Google Scholar
Nakamura, S, Kino, I, Akagi, T. Inflammatory myoglandular polyps of the colon and rectum. A clinicopathological study of 32 pedunculated polyps, distinct from other types of polyps. Am J Surg Pathol. 1992;16:772–9.Google Scholar
Williams, GT, Bussey, HJR, Morson, BC. Inflammatory ‘cap’ polyps of the large intestine. Br J Surg. 1985;72:133.Google Scholar
Madigan, MR, Morson, BC. Solitary ulcer of the rectum. Gut. 1969;10:871–81.Google Scholar
Chetty, R, Bhathal, PS, Slavin, JL. Prolapse-induced inflammatory polyps of the colorectum and anal transitional zone. Histopathology. 1993;23:63–7.Google Scholar
Brosens, LAA, Montgomery, EA, Bhagavan, BS, Offerhaus, GJA, Giardiello, FM. Mucosal prolapse syndrome presenting as rectal polyposis. J Clin Pathol. 2009;62:1034–6.Google Scholar
Parfitt, JR, Shepherd, NA. Polypoid mucosal prolapse complicating low rectal adenomas: beware the inflammatory cloacogenic polyp! Histopathology. 2008;53:91–6.Google Scholar
Pieterse, AS, Leong, AS, Rowland, R. The mucosal changes and pathogenesis of pneumatosis cystoides intestinalis. Hum Pathol. 1985;16:683–8.Google Scholar
Galandiuk, S, Fazio, VW, Petras, RE. Pneumatosis cystoides intestinalis in Crohn’s disease. Report of two cases. Dis Colon Rectum. 1985;28:951–6.Google Scholar
St Peter, SD, Abbas, MA, Kelly, KA. The spectrum of pneumatosis intestinalis. Arch Surg. 2003;138:68–75.Google Scholar
Gagliardi, G, Thompson, IW, Hershman, MJ, Forbes, A, Hawley, PR, Talbot, IC. Pneumatosis coli: a proposed pathogenesis based on study of 25 cases and review of the literature. Int J Colorectal Dis. 1996;11:111–18.Google Scholar
Matsumoto, A, Isomoto, H, Shikuwa, S, et al. Pneumatosis intestinalis in ulcerative colitis. Med Sci Monit. 2009;15: cs139–42.Google Scholar
Tsujimoto, T, Shioyama, E, Moriya, K, et al. Pneumatosis cystoides intestinalis following alpha-glucosidase inhibitor treatment: a case report and review of the literature. World J Gastroenterol. 2008;14:6087–92.Google Scholar
McCarthy, AJ, Lauwers, GY, Sheahan, K. Iatrogenic pathology of the intestines. Histopathology. 2015;66:15–28.Google Scholar
Bateman, AC. Miscellaneous disorders of the large intestine. In Shepherd, NA, Warren, BF, Williams, GT, Greenson, JK, Lauwers, GY, Novelli, MR (eds), Morson and Dawson’s Gastrointestinal Pathology, 5th ed. Oxford: Blackwell; 2013, 748–58.Google Scholar
Gui, X, Zhou, Y, Eidus, L, Falck, V, Gao, Z, Is, Qin L. Pneumatosis cystoides intestinalis gas-distended and ruptured lymphatics? Reappraisal by immunohistochemistry. Arch Pathol Lab Med. 2014;138:1059–66.Google Scholar
Koreishi, A, Lauwers, GY, Misdraji, J. Pneumatosis intestinalis: a challenging biopsy diagnosis. Am J Surg Pathol. 2007;31:1469–75.Google Scholar
Tagart, RE. Endometriosis of the large intestine. Br J Surg. 1959;47:27–34.Google Scholar
Spjut, HJ, Perkins, DE. Endometriosis of the sigmoid colon and rectum: a roentgenologic and pathologic study. Am J Roentgenol Radium Ther Nucl Med. 1959;82:1070–5.Google Scholar
Parker, RL, Dadmanegsh, F, Young, RH, Clement, PB. Polypoid endometriosis: a clinicopathologic analysis of 24 cases and a review of the literature. Am J Surg Pathol. 2004;28:285–97.Google Scholar
Yantiss, RK, Clement, PB, Young, RH. Endometriosis of the intestinal tract: a study of 44 cases of a disease that may cause diverse challenges in clinical and pathologic evaluation. Am J Surg Pathol. 2001;25:445–54.Google Scholar
Langlois, NE, Park, KG, Keenan, RA. Mucosal changes in the large bowel with endometriosis: a possible cause of misdiagnosis of colitis? Hum Pathol. 1994;25:1030–4.Google Scholar
Kelly, P, McCluggage, WG, Gardiner, KR, Loughrey, MB. Intestinal endometriosis morphologically mimicking colonic adenocarcinoma. Histopathology. 2008;52:510–14.Google Scholar
Kim, JS, Hur, H, Min, BS, et al. Intestinal endometriosis mimicking carcinoma of rectum and sigmoid colon: a report of five cases. Yonsei Med J. 2009;50:732–5.Google Scholar
Petersen, VC, Underwood, JCE, Wells, M, Shepherd, NA. Primary endometrioid adenocarcinoma of the large intestine arising in colorectal endometriosis. Histopathology. 2002;40:171–6.Google Scholar
Sladen, GE, Filipe, MI. Is segmental colitis a complication of diverticular disease? Dis Colon Rectum. 1984;27:513–14.Google Scholar
Polit, SA. Chronic segmental colitis in association with diverticulosis: a clinical syndrome in the elderly? J Am Geriatr Soc. 1993;41:1155–6.Google Scholar
Hart, J, Baert, F, Hanauer, S. Sigmoiditis: a clinical syndrome with a spectrum of pathological features, including a distinctive form of IBD. Mod Pathol. 1995;8:62A.Google Scholar
van Rosendaal, GM, Andersen, MA. Segmental colitis complicating diverticular disease. Can J Gastroenterol. 1996;10:361–4.Google Scholar
Evans, JP, Cooper, J, Roediger, WE. Diverticular colitis: therapeutic and aetiological considerations. Colorectal Dis. 2002;4:208–12.Google Scholar
Freeman, HJ. Natural history and long-term clinical behavior of segmental colitis associated with diverticulosis (SCAD syndrome). Dig Dis Sci. 2008;53:2452–7.Google Scholar

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