Crohn Disease and Ulcerative Colitis: A Photo Essay

October 16, 2012

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.  

Click here for the next image

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. 

Click here for the next image

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

Photo courtesy of David Schwartz, MD.  

Click here for the next image

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. 

Click here for the next image

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

Photo courtesy of David Schwartz, MD.  

Click here for the next image

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. 

Click here to return to first image