Περίληψη:
Background and Study Aims: This study assesses the diagnostic value of
colonoscopy performed at an early stage of a first attack of acute,
severe hemorrhagic colitis.
Patients and Methods: One hundred fourteen consecutive patients were
prospectively studied, The colonoscopic diagnosis was compared with the
final diagnosis of the colitis, which was based on clinical,
microbiological, endoscopic, and histological criteria during the acute
illness, but also on the results of a thirty-month follow-up of the
patients aiming to confirm whether the colitis was relapsing or
nonrelapsing in nature.
Results: The colonoscopic diagnosis was ulcerative colitis (UC) in 40,
Crohn’s disease in four, and infective colitis (IC) in 70 patients, The
endoscopic diagnosis was finally confirmed in all 40 UC patients and in
68 of 70 (97.1%) IC patients, Two patients with an initial endoscopic
and histological diagnosis of IC presented with typical attacks of UC 28
and 30 months later, respectively, Prominent endoscopic appearances in
IC were mucosal edema, erythematous areas, hemorrhagic spots, bleeding,
microaphthoid ulcers, and luminal exudate. Although rectal sparing was
occasionally seen, endoscopic lesions were continuous and severe in the
distal colon, but were patchily and unevenly distributed in other parts
of the colon in IC. In UC, prominent colonoscopic findings were
bleeding, mucosal friability, granularity, and ulceration; lesions were
continuously distributed in the involved area.
Conclusions: Colonoscopy is a useful procedure in the differential
diagnosis of severe bloody diarrhea of unknown cause.
Συγγραφείς:
Mantzaris, GJ
Hatzis, A
Archavlis, E
Petraki, K
Lazou, A
and Ladas, S
Triantafyllou, G
Raptis, SA
