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Granulomatous colitis in association with diverticula.

Abstract Ten patients 45 years of age or older were initially believed, on the basis of clinical and radiologic findings, to have diverticulitis of the sigmoid and descending colon. At operation the same diagnosis was entertained in nine on the basis of the gross findings. Pathological examination of the resected specimens, however, revealed typical lesions of granulomatous colitis. The history, physical examination and laboratory studies did not aid in the differential diagnosis except for the past history of perirectal disease in four patients. Analysis of the radiographic findings, however, revealed some distinguishing features, particularly the presence of a longitudinal, intramural fistulous tract extending parallel to the lumen in the thickened bowel. This finding is pathognomonic for granulomatous colitis.