Diverticular disease, complications re-visited.

Abstract

Introduction

Filiform polyposis of the colon is an uncommon entity occasionally encountered in patients with inflammatory bowel disease, characterised by multiple worm-like mucosal projections consisting of sub-mucosal cores lined by normal mucosa.

Case study

A 60-year-old man presented with signs and symptoms of large bowel obstruction for 7 days. The patient had a CT scan of the abdomen that showed thickening of the sigmoid wall with suspicion of malignancy. Subsequent colonoscopy showed an exophytictumour extending over 5 cm of the distal sigmoid. The biopsy showed only mucosal ulceration with no evidence of malignancy. The patient then underwent anterior resection of the sigmoid colon. The sigmoid colon was carpeted by numerous finger like projections. On histology this showed mucosal prolapse as a result of extensive diverticular disease.

Discussion

We discuss the unusual clinical presentation and gross findings of colonic polyposis related to diverticular disease. Only three similar cases have been reported in the English literature since 2010.