Japanese

Endoscopic and Histologic Features Associated with Refractory Ulcerative Colitis Masanori Tanaka 1 1Department of Pathology and Laboratory Medicine, Hirosaki City Hospital, Hirosaki, Japan Keyword: 潰瘍性大腸炎 , 難治性 , ステロイド抵抗性 , 病理学的所見 , 生検診断基準 pp.1903-1910
Published Date 2007/12/25
DOI https://doi.org/10.11477/mf.1403101245
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 Patients with ulcerative colitis (UC) follow various clinical courses and 17% to 38% ultimately require surgery. Endoscopic and histologic features associated with refractory UC are crudely divided into “severe and extensive inflammation” and ”inflammation unlike typical UC”. The former includes pancolitis, numerous crypt abscesses, extensive mucosal abrasion, and deep ulcers. The latter includes longitudinal ulcers, patchy inflammation, refractory lesions in the proximal colon, and relative rectal sparing, all of which are features reminiscent of Crohn's colitis. Paucity of eosinophils in the diseased mucosa also suggests a refractory course. Future endoscopic criteria predicting refractory UC have to include the above macroscopic features, and the densities of crypt abscesses and eosinophils should be incorporated into the pathology report.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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