Ulcerative colitis other diagnostic studies: Difference between revisions
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* Loss of the vascular appearance of the colon | * Loss of the vascular appearance of the colon | ||
* [[Erythema]] (or redness of the [[mucosa]]) and friability of the mucosa | * [[Erythema]] (or redness of the [[mucosa]]) and friability of the mucosa | ||
* Superficial ulceration, which may be confluent | * Superficial ulceration, which may be confluent | ||
* [[Polyp (medicine)|Pseudopolyps]] | * [[Polyp (medicine)|Pseudopolyps]] | ||
Ulcerative colitis is usually continuous from the [[rectum]], with the [[rectum]] almost universally being involved. There is rarely peri-anal disease, but cases have been reported. The degree of involvement endoscopically ranges from [[proctitis]] or inflammation of the rectum, to left sided colitis, to [[Colitis|pancolitis]], which is inflammation involving the ascending colon. | Ulcerative colitis is usually continuous from the [[rectum]], with the [[rectum]] almost universally being involved. There is rarely peri-anal disease, but cases have been reported. The degree of involvement endoscopically ranges from [[proctitis]] or inflammation of the rectum, to left sided colitis, to [[Colitis|pancolitis]], which is inflammation involving the ascending colon. | ||
Revision as of 16:15, 3 May 2013
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Ulcerative colitis Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Other Diagnostic Studies
Endoscopic
The best test for diagnosis of ulcerative colitis remains endoscopy. Full colonoscopy to the cecum and entry into the terminal ileum is attempted only if diagnosis of UC is unclear. Otherwise, a flexible sigmoidoscopy is sufficient to support the diagnosis. The physician may elect to limit the extent of the exam if severe colitis is encountered to minimize the risk of perforation of the colon. Endoscopic findings in ulcerative colitis include the following:
- Loss of the vascular appearance of the colon
- Erythema (or redness of the mucosa) and friability of the mucosa
- Superficial ulceration, which may be confluent
- Pseudopolyps
Ulcerative colitis is usually continuous from the rectum, with the rectum almost universally being involved. There is rarely peri-anal disease, but cases have been reported. The degree of involvement endoscopically ranges from proctitis or inflammation of the rectum, to left sided colitis, to pancolitis, which is inflammation involving the ascending colon.
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Histologic
Biopsies of the mucosa are taken to definitively diagnose UC and differentiate it from Crohn's disease, which is managed differently clinically. Microbiological samples are typically taken at the time of endoscopy. The pathology in ulcerative colitis typically involves distortion of crypt architecture, inflammation of crypts (cryptitis), frank crypt abscesses, and hemorrhage or inflammatory cells in the lamina propria. In cases where the clinical picture is unclear, the histomorphologic analysis often plays a pivotal role in determining the management.