SCAD: diverticular inflammation or IBD in diverticular ...

DIS
sa

 Pathogenesis

 Diagnosis

 Natural history

 therapy

SEASE DEFINITION:
ame or different?

• Clinical exam
• Endoscopy with/wo rad
• Histology

Diagnosis

diology

SCA

SCAD (‘‘segmental colitis associated with
diverticular disease’’) is defined as a
chronic colitis confined to the diverticular
segment in individuals with otherwise
uncomplicated diverticular disease.
By definition, the rectum and the proximal
colon are endoscopically and histologically
normal.

Tursi et al, Colorectal Disease, 12, 464–470, 2010

AD ENDOSCOPY

l
y

0

SCA

SCAD (‘‘segmental colitis associated with
diverticular disease’’) is defined as a
chronic colitis confined to the diverticular
segment in individuals with otherwise
uncomplicated diverticular disease.
By definition, the rectum and the proximal
colon are endoscopically and histologically
normal.

Tursi et al, Colorectal Disease, 12, 464–470, 2010

AD ENDOSCOPY

l
y

crescentic fold disease SCAD

0

SCA

SCAD (‘‘segmental colitis associated with
diverticular disease’’) is defined as a
chronic colitis confined to the diverticular
segment in individuals with otherwise
uncomplicated diverticular disease.
By definition, the rectum and the proximal
colon are endoscopically and histologically
normal.

Tursi et al, Colorectal Disease, 12, 464–470, 2010

AD ENDOSCOPY

l
y

UcreCs-cliekneticSCfoAldDdisease SCAD

0

SCA

SCAD (‘‘segmental colitis associated with
diverticular disease’’) is defined as a
chronic colitis confined to the diverticular
segment in individuals with otherwise
uncomplicated diverticular disease.
By definition, the rectum and the proximal
colon are endoscopically and histologically
normal.

Tursi et al, Colorectal Disease, 12, 464–470, 2010

AD ENDOSCOPY

l
y

UcreCs-cliekneticSCfoAldDdisease SCAD
CD-colitis like SCAD

0

SCA

SCAD (‘‘segmental colitis associated with
diverticular disease’’) is defined as a
chronic colitis confined to the diverticular
segment in individuals with otherwise
uncomplicated diverticular disease.
By definition, the rectum and the proximal
colon are endoscopically and histologically
normal.

Tursi et al, Colorectal Disease, 12, 464–470, 2010

AD ENDOSCOPY

l
y

UcreCs-cliekneticSCfoAldDdisease SCAD
SeCvDe-rceoUliCti-slilkikee-SSCCAADD

0

SCA

SCAD (‘‘segmental colitis associated with
diverticular disease’’) is defined as a
chronic colitis confined to the diverticular
segment in individuals with otherwise
uncomplicated diverticular disease.
By definition, the rectum and the proximal
colon are endoscopically and histologically
normal.

Tursi et al, Colorectal Disease, 12, 464–470, 2010

AD ENDOSCOPY

l
y

UcreCs-cliekneticSCfoAldDdisease SCAD
SeCvDe-rceoUliCti-slilkikee-SSCCAADD

0

SCA

Courtesy of dr V. Arena, anatomopathoogist, Cat

AD HYSTOLOGY

tholic University, Rome

SCA

Courtesy of dr V. Arena, anatomopathoogist, Cat

AD HYSTOLOGY

tholic University, Rome

SCA

Courtesy of dr V. Arena, anatomopathoogist, Cat

AD HYSTOLOGY

tholic University, Rome

SCA

Courtesy of dr V. Arena, anatomopathoogist, Cat

AD HYSTOLOGY

tholic University, Rome

SCAD

• SHORTENING OF THE BOWEL
• CREEPING FAT

(visible also at CT scan)
• ….
Courtesy of dr V. Arena, anatomopathoogist, Cat

D COMPLICATIONS

tholic University, Rome

SCAD

• SHORTENING OF THE BOWEL
• CREEPING FAT

(visible also at CT scan)
• ….
Courtesy of dr V. Arena, anatomopathoogist, Cat

D COMPLICATIONS

tholic University, Rome

SCAD

• SHORTENING OF THE BOWEL
• CREEPING FAT

(visible also at CT scan)
• ….
Courtesy of dr V. Arena, anatomopathoogist, Cat

D COMPLICATIONS

tholic University, Rome

SCAD

• SHORTENING OF THE BOWEL
• CREEPING FAT

(visible also at CT scan)
• ….
Courtesy of dr V. Arena, anatomopathoogist, Cat

D COMPLICATIONS

tholic University, Rome

Normal Mucosa

Courtesy of dr V. Arena, anatomopathoogist, Cat

tholic University, Rome

Cryptitis

Normal Mucosa

Courtesy of dr V. Arena, anatomopathoogist, Cat

tholic University, Rome

Cryptitis

Cryptic absess

Normal Mucosa

Courtesy of dr V. Arena, anatomopathoogist, Cat

tholic University, Rome

Cryptitis

Cryptic absess

Normal Mucosa

Courtesy of dr V. Arena, anatomopathoogist, Cat

Basal plasmocytosis

tholic University, Rome

Cryptitis

Cryptic absess

Normal Mucosa

Granulomat

Courtesy of dr V. Arena, anatomopathoogist, Cat

Basal plasmocytosis

tous inflamation

tholic University, Rome

Cryptitis

Cryptic absess

Normal Mucosa

Granulomat

Courtesy of dr V. Arena, anatomopathoogist, Cat

Basal plasmocytosis

tous inflamation Granulation

tholic University, Rome

Courtesy of dr V. Arena, anatomopathoogist, Cat

tholic University, Rome

Ulcer and cr

Discontinue inflamma

Courtesy of dr V. Arena, anatomopathoogist, Cat

rypt distortion

ation Deep layer involvement

tholic University, Rome

Ulcer and cr

Discontinue inflamma

Courtesy of dr V. Arena, anatomopathoogist, Cat

rypt distortion

ation Deep layer involvement

tholic University, Rome