Home   Chapter Home   Jobs   Conferences   Fellowships   Books



Advertisement

Small bowel (small intestine)

Inflammatory disorders

Ulcerative colitis


Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 16 December 2012, last major update August 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
=========================================================================

● Severe UC is associated with contiguous backwash ileitis and appendix involvement
● UC also associated with postcolectomy pouchitis
● Rarely diffuse duodenitis is associated with ulcerative colitis, but it does not behave as Crohn’s disease (Am J Surg Pathol 2000;24:1407)
● Diffuse chronic duodenitis in ulcerative colitis patients who have colectomy is a strong predictor of pouchitis (Am J Surg Pathol 2010;34:1672)

Backwash ileitis
=========================================================================

● Recommended to restrict use of term to active enteritis involving ileum contiguously from cecum that has a similar or greater degree of active inflammation; mild cases predominantly involves the superficial mucosa in a contiguous pattern
● Focal isolated ileal erosions, mucous gland metaplasia, or patchy edema with mild active inflammation are features of Crohn's disease (Am J Clin Pathol 2006;126:365)

Micro images
=========================================================================



Mild backwash ileitis in moderately active cecal chronic ulcerative colitis resection specimen; mucosa of distal ileum is edematous, and villi are slightly wider and flatter than norma; most of the active colitis stops abruptly at transition point between the 2 mucosae; the two most distal villi have the greatest degree of injury, including blunting, edema, and neutrophils in the lamina propria and surface epithelium


Moderate (left) and severe (center, right) backwash ileitis


Terminal ileum inflammation: (A) grade 1, cryptitis; (B) grade 2, scattered crypt abscesses
(C) grade 3, numerous crypt abscesses; (D) grade 4, ulcer


End of Small bowel (small intestine) > Inflammatory disorders > Ulcerative colitis


This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must be interpreted in the context of a patient's clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician.

All information on this website is protected by copyright of PathologyOutlines.com, Inc. Information from third parties may also be protected by copyright. Please contact us at copyrightPathOut@gmail.com with any questions (click here for other contact information).