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PubMed2005

Acute mesenteric infarction: an important cause of abdominal pain in ulcerative colitis.

We present four cases of acute mesenteric infarction in patients with active ulcerative colitis: one presenting prior to the diagnosis of ulcerative colitis, two at the time of diagnosis, and one many years after the diagnosis had been made. Intestinal ischaemia is an important part of the differential diagnosis in patients with ulcerative colitis presenting with abdominal pain. Conversely, in patients presenting with bloody diarrhoea after mesenteric ischaemia, ulcerative colitis should be considered.

Abdominal Pain↗
PubMedDate not supplied

Localized giant pseudopolyposis of the colon in ulcerative colitis.

Recently a patient with ulcerative colitis developed abdominal pain and a left upper quadrant mass. A 67Ga-citrate scintiscan showed increased activity over the mass. A barium enema demonstrated retrograde obstruction at the splenic flexure and intraluminal multilobulated tissue masses. The total abdominal colectomy specimen showed localized giant pseudopolyposis at the splenic flexure. This condition is a rare local complication of both ulcerative and granulomatous colitis. It resembles a villous adenoma on barium enema and, although inflammatory, may simulate a colonic carcinoma. When symptomatic, local resection may be sufficient treatment.

Adult↗
PubMed1982

Rectal malignant lymphoma in chronic ulcerative colitis.

Carcinoma of the colon as a complication of ulcerative colitis is relatively common, whereas malignant lymphoma is apparently rare; there are approximately 20 recorded cases. We report a case of follicular lymphoma of the rectum in a 73 year old woman with a 21 year history of ulcerative colitis. In view of the possible immune basis of ulcerative colitis, it is important to report and accurately classify cases of lymphoma arising in association with it.

Aged↗
PubMed2004

Restorative proctocolectomy in patients with ulcerative colitis having a recto-vaginal fistula.

OBJECTIVE: Recto-vaginal fistula is a rare complication of ulcerative colitis. There are few reports of restorative proctocolectomy carried out in patients with ulcerative colitis having a rectovaginal fistula. We report our experience with this condition. PATIENTS AND METHODS: Between 1 January 1976 and 31 December 2001, 838 patients underwent restorative proctocolectomy for ulcerative colitis at one hospital. These included 400 women of whom 4 (1%) had an already present rectovaginal fistula. We reviewed all patients who presented with a rectovaginal fistula. These patients were contacted by telephone to establish function and satisfaction. RESULTS: The mean age was 30.0 years (range 19-39 years). The mean age at onset of ulcerative colitis was 21.5 years (range 13-34 years). One patient was asymptomatic, the fistula being discovered at operation. In the other three patients the recto-vaginal fistula had occurred at a mean of 108 months (range 72-192 months) after the onset of ulcerative colitis. Three of four patients had had previous episodes of acute severe disease. Three patients had a narrow rectum with deep ulceration. The mean distance between the anorectal junction and the site of fistulation was 2.7 cm (range 0-7 cm). Three patients had a three-stage and one patient a two-stage procedure. Mean follow-up after closure of the loop ileostomy was 107 months (range 17-276 months). All patients were treated successfully but 2 (50%) had a recurrence at 156 and 40 months after the closure of the loop ileostomy. One patient was diverted and the fistula was closed by a subsequent transanal repair and the other patient was treated with success by temporary loose seton technique. Two patients had excellent functional results whereas two other had some difficulties in continence. Nevertheless all patients were satisfied with the outcome. CONCLUSIONS: Patients with ulcerative colitis and a recto-vaginal fistula can be successfully treated by restorative proctocolectomy, nevertheless they are at risk of late recurrence of the fistula.

Adult↗
PubMed2003

[Retrospective analysis of case histories of patients with ulcerative colitis and Crohn's disease].

Consistent patterns of inflammatory bowel diseases (IBD), difficulties of diagnosis Crohn's disease and ulcerative colitis and peculiarities of their treatment have been studied on the basis of retrospective analysis of IBD patient case histories during 1995-2001 in the Department of Gastroenterology of Kaunas University of Medicine Hospital. Ulcerative colitis and Crohn's disease are chronic diseases that influence the quality of life, mortality and number of hospitalizations with their course varying in different countries. The number of cases hospitalized during the five years period was 273; 80% of which was ulcerative colitis, whereas the percentage of Crohn's disease was 20. The number of cases of ulcerative colitis increased every year while that of Crohn's disease started to grow in 2001. IBD is more common among males than females. It was at the expanse of young females that patients with Crohn's disease were statistically significantly younger than those with ulcerative colitis. Proctosigmoiditis (45.9%) and left colitis (27.1%) are common predominants in ulcerative colitis, while ileocolitis (63.6%) predominates in Crohn's disease. Ulcerative colitis correlates with stool frequency and extent of disease. Course of IBD is rather grave and relapses are quite frequent.

Adult↗
PubMed1998

Mucosal metabolism in ulcerative colitis and Crohn's disease.

PURPOSE: Colonic mucosal metabolism of butyrate may be impaired in ulcerative colitis. In this study we sought to confirm this observation, to determine if a similar change occurs in Crohn's colitis, and to establish whether a panenteric disorder of butyrate metabolism exists in either condition. METHODS: With use of a microculture technique, mucosal metabolic fluxes of 14[C]-labeled butyrate and 14[C]-labeled glutamine were measured as 14[C] carbon dioxide production in mucosal biopsy specimens from the colon and ileum in patients with ulcerative colitis, Crohn's colitis, and healthy bowel. Results were expressed as pmol/microg biopsy DNA/hour. RESULTS: In the colon the mucosal metabolic fluxes of both butyrate and glutamine are reduced in both ulcerative colitis and Crohn's colitis compared with healthy controls. These changes were most marked in the presence of moderate to severe mucosal inflammation, there being no significant difference in mucosal metabolic flux between mildly inflamed mucosa and healthy controls. In the ileum the mucosal metabolic fluxes of butyrate and glutamine did not differ between healthy controls and those with either ulcerative colitis or Crohn's colitis. CONCLUSIONS: Changes in colonic mucosal metabolism of butyrate and glutamine in inflammatory bowel disease occur as a consequence of the inflammatory process and are not peculiar to ulcerative colitis. Ileal mucosal metabolism is unchanged in ulcerative colitis and Crohn's colitis, indicating the absence of a panenteric abnormality of mucosal metabolism in these two conditions.

Biopsy↗