Large bowel obstruction secondary to stenosing diverticular disease

Discussion:

The patient proceeded to colectomy.

Histopathology

MICROSCOPIC DESCRIPTION:

Sections show numerous outpouchings of the colonic mucosa extending deeply, through the muscularis propria.  There is frequently a surrounding cuff of lymphocytic inflammation including secondary follicles. The stricture shows marked fibrosis and distortion. No suppurative inflammation or perforation is identified.  The bowel wall at the edge of the defect described macroscopically is viable (suggesting surgical artefact), as are the resection margins.  There is no evidence of malignancy.

DIAGNOSIS:

Sigmoid colon resection and completion colectomy:  Widespread diverticular disease with a stricture in the sigmoid colon.

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