Colitis, Ulcerative ; classification ; diagnosis ; pathology ; Humans ; Inflammation ; Medicine, Chinese Traditional

Ulcerative colitis (UC), a kind of chronic nonspecific intestinal inflammation with unknown etiology, is very difficult to cure. It recurs often and even is accompanied with parenteral lesion. It has been rated as one of contemporary refractory diseases by World Health Organization. The author combines the pathological mechanisms of UC with the poison-evil theory and the collateral disease theory, and puts forward that "toxin impairing intestine collateral" pathogenesis theory. We believe that longer accumulation of damp-heat stasis toxin that damages the intestine collateral is the key cause for recurrence and relapses of UC. We explained its theory foundation in terms of pathogenesis of UC from Chinese medicine and modern medicine. The "toxin impairing intestine collateral" theory might perfect the syndrome typing system for UC, and provide a new way of thinking for treating UC.
Colitis, Ulcerative ; diagnosis ; etiology ; pathology ; Humans ; Medicine, Chinese Traditional ; methods

Nowadays, inflammatory bowel disease, such as ulcerative colitis and Crohn's disease, is increasing; however, infectious colitis, such as amebic colitis, is decreasing, so many doctors are not apt to be interested in infectious colitis. In addition, recently amebic colitis has been relatively rare in Korea, and the colonoscopic and the pathologic findings of amebic colitis are very similar to those of other inflammatory bowel diseases. As a consequence, the diagnosis is very difficult if the cyst or the trophozoite of the ameba is not found in the stool examination or in the tissue pathology. The authors experienced three cases in which initial diagnoses of tuberculous colitis, ulcerative colitis, and a simple ulcer were made based on colonoscopic and X-ray findings. However a colonoscopic biopsy revealed a trophozoite form of ameba in the tissue. Hence, a diagnosis of amebic colitis could be made with confidence. Based on these results, we insist that infectious colitis should be included in the differential diagnosis when making a diagnosis of inflammatory bowel disease. In addition, it is extremely important to consider all kinds of infectious colitis, such as amebic colitis.
Amoeba ; Biopsy ; Colitis* ; Colitis, Ulcerative ; Crohn Disease ; Diagnosis ; Diagnosis, Differential ; Dysentery, Amebic* ; Inflammatory Bowel Diseases ; Korea ; Pathology ; Trophozoites ; Ulcer

A case of rather typical Crohn's disease in a 10 year old girl is described. She had suffered from intractable abdominal pain, diarrhea and fever for 1 year. Eventual right hemicolectomy revealed diffuse involvement of terminal ileum, cecum and ascending colon by confluent ulcerations and transmural inflammation. Histologically there were numerous well developed non-caseating granulomas scattered transmurally and in regional lymph nodes. Deep penetrating ulcerations were characteristic. Acid fast staining failed to demonstrate any organism. The rarity of Crohn's disease in Korea and this occurrence in pediatric age prompted this report.
Child ; Colitis/pathology ; Crohn Disease/diagnosis/*pathology ; Diagnosis, Differential ; Female ; Granuloma/pathology ; Humans ; Ileitis/pathology ; Intestines/pathology

No abstract availble.
Colitis, Ulcerative/complications/*diagnosis/pathology ; Colonoscopy ; Female ; Humans ; Intestinal Obstruction/*diagnosis/etiology/pathology ; Middle Aged

BACKGROUND/AIMS: Ulcerative colitis is an inflammatory bowel disease with unknown etiology, which has waxed and waned course. It is diagnosed by colon study, pathology, and especially colonoscopy. It is difficult to differentiate between ulcerative colitis and other infectious colitis, especially amebic colitis, and to confirm of remnant lesion by endoscopic findings. METHODS: Magnifying colonoscopy has 100 time magnifying power compared to 30 time of conventional colonoscopy. By spraying 0.2% indigo carmine dye, we evaluated the magnifying and microscopic findings of 31 colonic mucosa of 23 patients with ulcerative colitis. RESULTS: Initial and magnifying chromoscopic findings in ulcerative colitis were loss of cryptal opening 72% (13/18), loss of submucosal vessel 89% (16/18), mucosal denudation (or microscopic erosion) 83% (15/18), and mucosal unevenness 94% (17/18). Recovery rate of magnifying chromoscopic findings after treatment in ulcerative colitis were in crytal opening 80% (8/10), submucosal vascularity 60% (6/10), mucosal denudation (microscopic erosion) 30% (3/10), and in mucosal unevenness 40% (4/10). CONCLUSIONS: It is suggested that magnifying chromoscopic findings in ulcerative colitis may be useful in initial diagnosis and confirmation of remnant lesion, but, not in prediction of clinical severity.
Colitis ; Colitis, Ulcerative* ; Colon ; Colonoscopy ; Diagnosis ; Dysentery, Amebic ; Humans ; Indigo Carmine ; Inflammatory Bowel Diseases ; Mucous Membrane ; Pathology ; Ulcer*

BACKGROUND/AIMS: Although normal endoscopic findings are, as a rule, part of the diagnosis of microscopic colitis, several cases of macroscopic lesions (MLs) have been reported in collagenous colitis, but hardly in lymphocytic colitis (LC). The aim of this study was to investigate the endoscopic, clinical, and histopathologic features of LC with MLs. METHODS: A total of 14 patients with LC who were diagnosed between 2005 and 2010 were enrolled in the study. Endoscopic, clinical, and histopathologic findings were compared retrospectively according to the presence or absence of MLs. RESULTS: MLs were observed in seven of the 14 LC cases. Six of the MLs exhibited hypervascularity, three exhibited exudative bleeding and one exhibited edema. The patients with MLs had more severe diarrhea and were taking aspirin or proton pump inhibitors. More intraepithelial lymphocytes were observed during histologic examination in the patients with MLs compared to the patients without MLs, although this difference was not significant. The numbers of mononuclear cells and neutrophils in the lamina propria were independent of the presence or absence of MLs. CONCLUSIONS: LC does not always present with normal endoscopic findings. Hypervascularity and exudative bleeding are frequent endoscopic findings in patients with MLs.
Adult ; Aged ; Colitis, Collagenous/*pathology ; Colitis, Lymphocytic/complications/*pathology ; Colon/pathology ; *Colonoscopy ; Diagnosis, Differential ; Diarrhea/etiology ; Female ; Humans ; Intestinal Mucosa/*pathology ; Male ; Middle Aged ; Retrospective Studies

BACKGROUND/AIMS: Although normal endoscopic findings are, as a rule, part of the diagnosis of microscopic colitis, several cases of macroscopic lesions (MLs) have been reported in collagenous colitis, but hardly in lymphocytic colitis (LC). The aim of this study was to investigate the endoscopic, clinical, and histopathologic features of LC with MLs. METHODS: A total of 14 patients with LC who were diagnosed between 2005 and 2010 were enrolled in the study. Endoscopic, clinical, and histopathologic findings were compared retrospectively according to the presence or absence of MLs. RESULTS: MLs were observed in seven of the 14 LC cases. Six of the MLs exhibited hypervascularity, three exhibited exudative bleeding and one exhibited edema. The patients with MLs had more severe diarrhea and were taking aspirin or proton pump inhibitors. More intraepithelial lymphocytes were observed during histologic examination in the patients with MLs compared to the patients without MLs, although this difference was not significant. The numbers of mononuclear cells and neutrophils in the lamina propria were independent of the presence or absence of MLs. CONCLUSIONS: LC does not always present with normal endoscopic findings. Hypervascularity and exudative bleeding are frequent endoscopic findings in patients with MLs.
Adult ; Aged ; Colitis, Collagenous/*pathology ; Colitis, Lymphocytic/complications/*pathology ; Colon/pathology ; *Colonoscopy ; Diagnosis, Differential ; Diarrhea/etiology ; Female ; Humans ; Intestinal Mucosa/*pathology ; Male ; Middle Aged ; Retrospective Studies

Adult ; Colitis ; diagnosis ; surgery ; Cysts ; diagnosis ; surgery ; Female ; Humans ; Rectum ; pathology ; surgery

Child ; Colitis ; diagnosis ; Colon, Sigmoid ; pathology ; Diagnosis, Differential ; Diarrhea ; etiology ; Eosinophilia ; complications ; diagnosis ; Female ; Gastroenteritis ; complications ; diagnosis ; pathology ; Humans ; Sigmoid Diseases ; complications ; diagnosis ; pathology ; Sigmoidoscopy