Schembri John, Bonello John, Christodoulou Dimitrios K, Katsanos Konstantinos H, Ellul Pierre
Department of Internal Medicine, Division of Gastroenterology, Mater Dei Hospital, Malta (John Schembri, John Bonello, Pierre Ellul).
Division of Gastroenterology, School of Health Sciences, University of Ioannina, Ioannina Greece (Dimitrios K. Christodoulou, Konstantinos H. Katsanos).
Ann Gastroenterol. 2017;30(3):257-261. doi: 10.20524/aog.2017.0126. Epub 2017 Jan 31.
Segmental colitis associated with diverticulosis (SCAD) is an inflammatory process that affects colonic luminal mucosa in segments that are also affected by diverticulosis. Its prevalence varies between 1.15% and 11.4% amongst those suffering from diverticular disease (DD). Being closely associated with DD, it is slightly commoner in males and usually presents in the sixth decade of life. Although the exact pathogenesis of SCAD is unknown, it is probably heterogeneous and includes mechanisms that also play a part in inflammatory bowel disease (IBD). The clinical presentation is non-specific and similar to that of other pathologies involving the sigmoid colon, and its diagnosis is based on endoscopic findings in correlation with histology. Currently, there are no guidelines for its management, which is usually based on the administration of salicylates and antibiotics, with surgery being reserved for refractory cases. The rarity of SCAD may be multifactorial: whereas milder forms go undiagnosed or are attributed to DD, more severe forms can be misdiagnosed as IBD. This latter distinction is an important one to make, since SCAD and IBD differ as regards their natural history and prognosis, while very often no long-term medications are required in SCAD.
与憩室病相关的节段性结肠炎（SCAD）是一种炎症过程，影响与憩室病相关节段的结肠腔黏膜。在患有憩室病（DD）的人群中，其患病率在1.15%至11.4%之间。由于与DD密切相关，它在男性中略为常见，通常在生命的第六个十年出现。虽然SCAD的确切发病机制尚不清楚，但它可能是异质性的，包括在炎症性肠病（IBD）中也起作用的机制。临床表现不具特异性，与其他累及乙状结肠的病变相似，其诊断基于内镜检查结果并与组织学相关联。目前，对于其治疗尚无指南，治疗通常基于使用水杨酸盐和抗生素，手术仅用于难治性病例。SCAD的罕见可能是多因素的：较轻的形式未被诊断或归因于DD，而较严重的形式可能被误诊为IBD。后一种区分很重要，因为SCAD和IBD在其自然史和预后方面有所不同，而SCAD通常不需要长期用药。
