Diverticular disease includes a spectrum
of conditions ranging from asymptomatic
diverticular disease, to symptomatic
uncomplicated diverticular disease, and
complicated diverticular disease that
includes acute and chronic diverticulitis.
Diverticulitis is defined as an inflammation of
one or more diverticula, which are small
pouches created by herniation of mucosa
into the wall of the colon. Diverticulitis is
generally considered a disease of the
elderly, but as many as 20% of patients
with diverticulitis are younger than 50
Fistula formation is a complication of diverticulitis. Fistulas
to adjacent organs and the skin may develop, especially
in the presence of an abscess.
In men, colovesicular fistulas are the most common.
In women, the uterus is interposed between the colon and
the bladder, and this complication is only seen following
a hysterectomy. The uterus precludes fistula formation
from the sigmoid colon to the urinary bladder. However,
colovaginal and colocutaneous fistulas can form but are
associated with diverticulitis).
SCAD is a unique form of chronic colitis limited
to areas of the colon with diverticular formation.
Gore et al. first reported on the presence of an
entity they termed “diverticular colitis”.
Often mistakenly diagnosed as either ulcerative
colitis or Crohn’s disease, patients typically
present with pain and intermittent rectal