Diverticulitis and ulcerative colitis

The association of diverticulitis and acute ulcerative colitis is uncommon but carries a high mortality. Four cases are described with diverticular disease who developed fulminating ulcerative colitis. The double diagnosis was not initially recognized in any of these cases and in 2 the diagnosis of ulcerative colitis was only made at laparotomy.

Three of the 4 patients died following surgical treatment and the difficulties of their diagnosis and management are discussed. It is suggested that sigmoidoscopic examination before emergency bowel surgery is important.

Management of uncomplicated diverticular disease by colonic resection in patients at St. Mark's Hospital, 1964-9

One-hundred and thirty-nine resections were performed for diverticular disease at St. Mark's Hospital, London, during the period from 1964 to 1969. One hundred and three of the resections were done on selected cases before any of the clinically recognized complications of the disease had occurred. In 46 of the resected specimens no evidence of inflammation could be found despite meticulous examination by the pathologist.

The surgical procedures were accompanied by no mortality, moderate morbidity, and a gratifying relief of symptoms, which are contrary to the generally held belief that surgery for diverticular disease is hazardous.

Colonoscopy in the differential diagnosis of carcinoma from diverticulitis of the sigmoid colon

Thirty-six patients in whom barium-enema examination had suggested the possibility of carcinoma in a segment of diverticular disease were examined by colonoscopy. Colonoscopy is particularly difficult in such patients and it failed to examine the diseased segment in 17 cases. Colonoscopy gave a firm diagnosis of carcinoma in 4 cases, excluded it in 5, and was helpful in another 9. There was 1 false negative.

Diagnosis of diverticulitis of the colon: role of the barium enema in defining pericolic inflammation

Images