Noninfectious colitis

Diversion colitis

Topic Completed: 1 May 2013

Minor changes: 7 December 2020

Copyright: 2003-2021,, Inc.

PubMed Search: diversion colitis

Hanni Gulwani, M.B.B.S.
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Cite this page: Gulwani H. Diversion colitis. website. Accessed October 28th, 2021.
Definition / general
  • Also called defunctionalized bowel
  • Due to dietary deprivation of short chain fatty acids normally produced by colonic bacteria, important for caloric supply of colonic enterocytes
  • Similar histologic features regardless of cause for diversion, although patients with inflammatory bowel disease (IBD) may have superimposed IBD histologic changes
  • In children, resembles normal appendix (Histopathology 2000;36:41, Hum Pathol 1993;24:211)
  • Ileostomy, colostomy, other surgical diversion
Clinical features
  • Symptoms varies from none to severe diarrhea resembling ulcerative colitis
  • Can only diagnose with confidence if colon was noninflamed at time of surgical diversion
Case reports
Gross description
  • Varies from minimal mucosal friability to ulceration
Microscopic (histologic) description
  • Marked lymphoid hyperplasia resembling follicular proctitis or aphthous lesions, initially in lamina propria but later transmural (Am J Surg Pathol 1990;14:548, Hum Pathol 1990;21:429)
  • Mild colitis with crypt abscesses
  • Late in disease develop muscularis mucosa hypertrophy, fatty and fibrous infiltration of submucosa, thickened muscularis propria and narrow lumen (Colorectal Dis 2007;9:601); no architectural distortion
Microscopic (histologic) images

Images hosted on other servers:

Diversion proctitis
with diffuse chronic
inflammation but no
architectural distortion
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Image 01 Image 02