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

No abstract available.
Amyloidosis/complications/*diagnosis/pathology ; Colitis, Ulcerative/diagnosis ; Colonoscopy ; Gastrointestinal Hemorrhage/*etiology ; Heart Ventricles/radiography ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged

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

Cytomegalovirus (CMV) colitis is common among immunocompromised patients, and often diagnosed by pathologic confirmation because it is associated with a diverse spectrum of clinical and endoscopic features. However, Crohn's disease has no definitive diagnostic criteria, but longitudinal ulcers and cobble stone appearance are accepted as typical endoscopic features of Crohn's disease. An 83 year-old male with a history of radiotherapy for hypopharyngeal cancer visited our hospital with a complaint of melena for 1 week. His colonoscopic exam showed multiple longitudinal ulcers along the entire colon. Most of the ulcers were longer than 4 cm, these endoscopic findings were suspected as typical endoscopic features of Crohn's disease. Pathologic reports revealed multiple inclusion bodies with CMV on immunohistochemistry. He was finally diagnosed as having CMV colitis, and received a 3 week-course of intravenous ganciclovir. A colonoscopic follow-up showed complete healing of the multiple longitudinal ulcers, and he is doing well now without further treatment.
Aged, 80 and over ; Antiviral Agents/therapeutic use ; Colitis/*diagnosis/etiology/pathology ; Colonoscopy ; Crohn Disease/diagnosis ; Cytomegalovirus Infections/*diagnosis/drug therapy/pathology ; Ganciclovir/therapeutic use ; Humans ; Immunohistochemistry ; Injections, Intravenous ; Male ; Tomography, X-Ray Computed

Adult ; Anti-Inflammatory Agents, Non-Steroidal ; adverse effects ; therapeutic use ; CD3 Complex ; metabolism ; Colitis, Ulcerative ; drug therapy ; Diagnosis, Differential ; Drug Hypersensitivity ; etiology ; metabolism ; pathology ; Female ; Gastrointestinal Agents ; adverse effects ; therapeutic use ; Humans ; Immunoblastic Lymphadenopathy ; metabolism ; pathology ; Ki-1 Antigen ; metabolism ; Lymphadenitis ; chemically induced ; metabolism ; pathology ; Lymphoma, Large-Cell, Anaplastic ; metabolism ; pathology ; Lymphoma, T-Cell ; metabolism ; pathology ; Receptors, Complement 3d ; metabolism ; Sulfasalazine ; adverse effects ; therapeutic use

Inflammatory bowel disease often involves extra-intestinal organs. Cerebral thrombosis, portal vein thrombosis and pulmonary thrombosis have been reported. Deep vein thrombosis and pulmonary thromboembolism are significant causes of mortality in patients with inflammatory bowel disease. A 48-year-old woman was diagnosed as inflammatory bowel disease on colonoscopy and histology. We used hydrocortisone and mesalazine for the treatment of disease. Nineteen days later, she complained of abrupt dyspnea. Pulmonary CT angiography revealed a thromboembolism in right pulmonary arteries. After the treatment of heparin therapy, follow-up pulmonary CT angiography showed significant improvement of previously thrombosed pulmonary arteries.
Acute Disease ; Colitis, Ulcerative/complications/*diagnosis ; Colonoscopy ; Female ; Humans ; Middle Aged ; Pulmonary Embolism/*diagnosis/etiology/pathology ; Tomography, X-Ray Computed

BACKGROUND/AIMS: Focally enhanced gastritis (FEG) has been suggested as a specific diagnostic marker for patients with Crohn's disease (CD). However, the usefulness of FEG for distinguishing CD from ulcerative colitis (UC) is uncertain and the incidence or prevalence of FEG for inflammatory bowel disease (IBD) patients in Korea has not been defined yet. In this study, we investigated the frequency of FEG and other gastric histological abnormalities in Korean patients with CD and UC. METHODS: We evaluated 37 patients with known CD, 43 patients with UC and 41 non-IBD control group; all underwent upper gastrointestinal endoscopy followed by biopsy from the antrum and the body. The pathology of the gastric biopsy specimens and the presence of Helicobacter pylori (H. pylori) were evaluated. FEG was characterized by a focal perifoveolar or periglandular inflammatory cell infiltrates. RESULTS: H. pylori positive gastritis was found in 10 of 37 (27.0%) of CD patients, in 16 of 43 (37.2%) of UC patients, and in 22 of 41 (53.7%) of non-IBD control group (p=0.054). In H. pylori-negative patients, FEG was found in 8 of 27 patients (29.6%) of CD patients, 6 of 27 (22.2%) patients with UC, and 2 of 9 (10.5%) of non-IBD control group (p=0.324). CONCLUSIONS: In H. pylori-negative patients, there was no statistically significant difference in the occurrence of FEG among CD, UC and control groups in Korea.
Adult ; Colitis, Ulcerative/*diagnosis/etiology/pathology ; Crohn Disease/*diagnosis/etiology/pathology ; Female ; Gastritis/epidemiology/*pathology ; Gastroscopy ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Upper Gastrointestinal Tract/pathology

Escherichia coli (E coli) O157 may cause abdominal pain and diarrhea followed by hematochezia. Most of cases resolve spontaneously after several days. Takayasu's arteritis affects medium- and large-sized arteries, aortic arch and its branch, and rarely affects inferior mesenteric artery. In case of Takayasu's arteritis with hematochezia, we must distinguish among ulcerative colitis, ischemic colitis, and infectious colitis with Takayasu's arteritis. We report a case of 17-year-old woman who suffered from hemorrhagic colitis by E. coli O157, and combined with leg claudication and abdominal pain by Takayasu's arteritis that affected abdominal aorta and inferior mesenteric artery. Sigmoidoscopy showed edematous, hyperemic mucosa and superficial ulcerations in the sigmoid colon. Abdominal CT scan showed diffuse submucosal edema, narrowing of distal abdominal aorta and inferior mesenteric artery. Hematochezia disappeared after the conservative treatment and leg claudication and abdominal pain disappeared after the aortic angioplasty.
Adolescent ; Angiography ; Colitis/*diagnosis/etiology/pathology ; Escherichia coli Infections/complications/*diagnosis ; *Escherichia coli O157 ; Female ; Gastrointestinal Hemorrhage/*diagnosis/etiology ; Humans ; Imaging, Three-Dimensional ; Sigmoidoscopy ; Takayasu Arteritis/*radiography/therapy ; Tomography, Spiral Computed

Idiopathic mesenteric phlebosclerosis, rare disease entity causing chronic mesenteric ischemia is a member of non-thrombotic, non-inflammatory stenosis or occlusion of the mesenteric veins. The histologic hallmark is marked fibrous mural thickening and sclerosis of the vessel wall. It is frequently accompanied by calcification in the vessel wall. We report the case of a 61-year-old woman with idiopathic mesenteric phlebosclerosis. To our knowledge, this is the first case reported in Korea.
Calcinosis/diagnosis ; Colitis, Ischemic/diagnosis/etiology ; Colonoscopy ; Female ; Humans ; Mesenteric Vascular Occlusion/*diagnosis/etiology/pathology ; Mesenteric Veins/*pathology ; Middle Aged ; Sclerosis/pathology ; Tomography, X-Ray Computed