Question 161

Question:

A 73-year-old woman has episodes of abdominal pain and increasingly severe constipation. Test of the stool for occult blood is positive. The photomicrograph shows features of the resected colon. Which of the following is the most likely diagnosis?

Correct Answer: B.  Diverticular disease

The symptoms and histology are typical for diverticulitis, the inflammation of a false pocket (diverticulum) consisting of mucosa and submucosa which have herniated through the muscularis layer. Diverticulitis affects older persons and typically presents with abdominal pain and rectal bleeding. Complications frequently include bowel stenosis, peritonitis, and abscess formation.
Choice A, C and D are incorrect because colon tumors typically present as polyps rather than pockets.
Choice E is incorrect because volvulus, an abnormal twisting of the intestine which impedes blood flow, typically has a sudden onset and does not display the histology shown here.