Patient presents with refractory inflammatory bowel symptoms with diarrhoea, pain and per rectum bleeding.
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Segment of colon showing; extensive congestion and haemorrhage, irregular ulceration with pseudopolyp formation, and only minimal wall thickening.
The macroscopic features favour ulcerative colitis; this is based on continuous ('diffuse') ulceration, pseudopolyps (they are not true polyps, rather they are islands of residual intact mucosa within an area of ulceration), the muscualris propria and serosa are unremarkable (c.f. Crohn disease).