Diseases of the Colon, Rectum and Anus

inflammatory diseases of the colon, colonic diverticular disease, other lesions of the colon



Ischemic Colitis

Ischemic colitis is characterized by the abrupt onset of lower abdominal pain and rectal bleeding. Diarrhea is common, as is abdominal tenderness on physical examination. Most patients are over the age of 50 years, and many have a history of prior cardipyascular disease. The radiographic appearance of ischemic colitis depends on the phase of the process during which the patient is examined. Because the mucosa is the layer most dependent on intact vascularity, fine superficial ulceration associated with inflammatory edema is the earliest radiographic sign of ischemic colitis. This causes the outer margin of the barium-filled colon to appear serrated, simulating […]

Crohn’s Colitis

Crohn’s disease of the colon is identical to the same pathologic process involving the small bowel and must be distinguished from ulcerative colitis, the other main cause of “nonspecific” inflammatory disease of the colon. The proximal portion of the colon is most frequently involved in Crohn’s disease; concomitant disease of the terminal ileum is seen in up to 80 percent of patients. Unlike ulcerative colitis, Crohn’s colitis often spares (he rectum, and isolated rectal disease very rarely occurs. Crohn’s disease usually has a patchy distribution, with involvement of multiple, noncontiguous segments of colon (skip lesions), unlike the continuous colonic involvement […]

Complications of Ulcerative Colitis

Toxic Megacolon   Toxic megacolon is a dramatic and ominous complication of ulcerative colitis. It is characterized by extreme dilatation of a segment of colon, or an entire diseased colon, combined, with systemic toxicity (abdominal pain and tenderness, tachycardia, fever, and leukocytosis). Pathologically, specimens from patients with toxic megacolon show extensive deep ulcerations and acute inflammation involving the muscular layer of the colon and often extending to the serosa. The wall of the colon is extremely thin and friable, predisposing to perforation. In most patients with toxic megacolon, a simple plain film of the abdomen demonstrating marked distension of the […]

Ulcerative Colitis

Ulcerative colitis is primarily a disease of young adults, the peak incidence being in persons between 20 and 40 years of age. Ulcerative colitis is highly variable in severity, clinical course, and ultimate prognosis. The onset of the disease, as well as subsequent exacerbations, can be insidious or abrupt. The major symptoms include bloody diarrhea, abdominal pain, fever, and weight loss. A characteristic feature of ulcerative colitis is alternating periods of remission and exacerbation. Most patients have intermittent episodes of symptoms with complete remission between attacks. In fewer than 15 percent of patients, ulcerative colitis presents as an acute fulminating process. Patients […]

Inflammatory Diseases of the Colon

Ulcerative inflammation of the colon or rectum is a nonspecific response to a host of harmful agents and processes. In many cases, an ulcerating colitis can be attributed to a specific infectious disease, systemic disorder, or toxic agent. However, in a large group of patients, a precise cause cannot be determined. Most of these “nonspecific” inflammatory diseases ot the colon are generally placed into one of two categories: ulcerative colitis or Crohn’s disease. Although radiographic and pathologic criteria have been established tor distinguishing between these two processes, there Is a substantial overlap in practice. In at least 10 percent of […]

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