Idiopathic muscular strictures of the sigmoid colon.

In a paper dealing with diverticular disease, Morson (1963) stated that four out of 155 specimens of sigmoid colon removed at St. Mark's Hospital, London, for 'diverticulitis' showed an increase of the muscular thickness of the wall without any detectable diverticula. There were no signs of inflammation in the wall, and the muscular abnormality could be compared to that seen in patients with diverticulosis. From this observation, he suggested that the muscular thickening could precede the appearance of diverticula or predispose to the occurrence of diverticulosis. This hypothesis seems to have been confirmed by Arfwidsson (1964) who found initial intramural diverticula in cases of spastic colon with remarkable thickening of the musculature. The muscular involvement of the colon in diverticulitis has also been pointed out by Celio (1952) who compared the myopathic component of the disease to the hypertrophic stenosis of the pylorus. Idiopathic muscular strictures of the large bowel in human beings have not been described until now. In the horse, segmental muscular stenosis has been mentioned in the oesophagus and small intestine (Helmke, 1939). We have observed two cases of muscular stricture of the sigmoid not related to diverticular or other diseases. It seems helpful to give a brief description of our experience.