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• W2992143079 abstract "Background: Mucosal inflammation isolated to a segment of colon affected by diverticular disease with relative sparing of the rectum refers to Segmental Colitis Associated with Diverticulosis (SCAD, also known as Diverticular Disease-Associated Colitis (DDAC). Although SCAD is relatively rare, its clinical and pathologic resemblance to inflammatory bowel disease (IBD) represents a diagnostic challenge for clinicians and misdiagnosis can lead to its mismanagement. Objective: This study aimed to demonstrate that early elective colonic resection for symptomatic SCAD should be the treatment following a short course of conservative management with mesalamine derivatives. Design: This was a single-institution, retrospective observational study combined with a systematic review of the literature. Data Sources: Morristown Medical Center institutional database. Medline. EMBASE. Cochrane. Interventions: Medical therapy included anti-inflammatory and immunosuppressive agents currently used for IBD. Surgical therapy included segmental colonic or more extensive resections with or without primary anastomosis. Outcome Measures: Symptomatic or endoscopic recurrences at follow up Results: Our literature review yielded seventeen studies with two hundred-forty patients. Of these, 169 patients were managed medically. Eighty-five patients either initially or eventually required surgery. Study duration ranged from 0 to 15 years. Recurrence rate in the medically managed cohort was 26.0% (44/169) compared to the surgical cohort 10.5% (9/85). In our database, we found a total of seven patients (5 males and 2 females; mean age 62.9) all with endoscopically diagnosed acute-on-chronic colitis associated with diverticular disease. Two patients underwent Hartmann’s procedure, and five underwent segmental colectomy with primary anastomosis. Follow up ranged from 0-5 years, and four patients had surveillance colonoscopies that were negative for recurrence. Limitations: The study was limited by its retrospective nature and small sample size. Conclusions: Medical treatment does not alter the natural history of SCAD, and more aggressive subtypes will chronically recur or develop complications. In our experience, surgical intervention following a short treatment course of Mesalamine treatment will afford patients treatment with low morbidity and improved quality of life." @default.
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• W2992143079 date "2016-01-01" @default.
• W2992143079 modified "2023-09-24" @default.
• W2992143079 title "Surgical Resection As Treatment For Segmental Colitis Associated With Diverticulosis (SCAD)" @default.
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