Ulcerative colitis - pancolitis on presentation

Case contributed by Michael P Hartung
Diagnosis certain

Presentation

Abdominal discomfort for several months.

Patient Data

Age: 22 years
Gender: Male

Diffuse thickening of the large bowel and rectum, greatest in the right colon. Relative loss of haustral features in the descending and sigmoid colon. No other significant abnormalities.

Case Discussion

Pancolitis involving the rectum typically indicates infectious or inflammatory colitis. Inflammatory colitis (specifically ulcerative colitis) is suspected more with a subacute onset in the at-risk age groups, as in this case. It is also worthwhile to check for spondyloarthropathy/SI joint involvement, which can help to increase your suspicions when positive. The diagnosis of UC was confirmed with colonoscopic biopsy.

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