|Articles|October 16, 2012

Crohn Disease and Ulcerative Colitis: A Photo Essay

Ulcerative colitis is primarily a mucosal disease, and other changes appear to be secondary to this process. By contrast, Crohn disease, or granulomatous colitis, involves the whole thickness of the bowel wall.

In approximately 40% of patients, Crohn disease affects the terminal ileum (Figure) and the cecum.

Photo courtesy of Michael F. Picco, MD, PhD.

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Crohn disease presents as isolated colonic disease in approximately 25% of patients. Colonic involvement may be patchy or continuous from the rectum; the latter presentation may be difficult to distinguish from ulcerative colitis.

Photo courtesy of Michael F. Picco, MD, PhD.

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This colonoscopic image shows the moderate to severe inflammation of the ileum typical of Crohn disease.

Photo courtesy of David Schwartz, MD.

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This colonoscopic view of the ileum-from a slightly different angle than the one on the previous page-also shows the moderate to severe inflammation typical of Crohn disease.

Photo courtesy of David Schwartz, MD.

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Severe colitis is characterized by ulceration, friability, and mucopurulent exudates.

Photo courtesy of David Schwartz, MD.

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Pseudopolyps (distinct, irregular raised areas of normal-appearing mucosa) are seen here among areas of friability, fibrous stranding, and ulceration in a patient with ulcerative colitis. The growths-a combination of reactive hyperplasia and mucosal ulceration, are not an uncommon finding in patients with severe or chronic ulcerative colitis.

Photo courtesy of Chad M. Sisk, DO.

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Crohn Disease and Ulcerative Colitis: A Photo Essay

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