Theme |
Atypical cases of inflammatory bowel disease diagnosed with difficulty |
Title |
Atypical endoscopic features in ulcerative colitis |
Author |
Takuya Inoue |
Second Department of Internal Medicine, Osaka Medical Callege / Inoue Gastroenterology & Endoscopy Clinic |
Author |
Mitsuyuki Murano |
Murano Clinic |
Author |
Kazuki Kakimoto |
Second Department of Internal Medicine, Osaka Medical Callege |
Author |
Toshihiko Okada |
Second Department of Internal Medicine, Osaka Medical Callege |
Author |
Ken Kawakami |
Second Department of Internal Medicine, Osaka Medical Callege |
Author |
Kazuhide Higuchi |
Second Department of Internal Medicine, Osaka Medical Callege |
[ Summary ] |
Endoscopy is an important diagnostic modality in ulcerative colitis because endoscopic features of ulcerative colitis are characterized by diffuse loss of vascular pattern, small yellowish spots, and mucous exudates. Since endoscopic features of ulcerative colitis are characteristic and atypical features are rarely observed during colonoscopic procedures, diagnostic strategy based on endoscopic features has not been complicated. However, endoscopic technology and the method of bowel preparation have recently improved considerably. Therefore, we are often aware of atypical endoscopic features, such as appendiceal orifice inflammation, aphthoid lesions, and skip lesions of inflammation. Thus far, the clinical implications of these atypical endoscopic features have not been determined. Atypical lesions without gross appearance often make endoscopic diagnosis difficult. However, these atypical features include the possibility of early lesions of ulcerative colitis. Careful follow-up is required. |