ULCERATIVE COLOTIS

Ulcerative colitis

Gareth P. Jevon (2010); GH, 6(3): 174–180

• continuous, circumferential mucosal inflammation

• diffuse erythema, edema, friability

• disappearance of vascular pattern, grayish exudates, erosions, or shallow ulcers

• rectal involvement

George Gershman (2012), “Practical pediatric gastrointestinal endoscopy”.

Lesion: Ulcerative colitis. Diffuse inflammation is typical for ulcerative colitis: erythema, exudates, loss of vascular pattern.

UC

George Gershman (2012), "Practical pediatric gastroinntestinal endoscpoy"

Lesion: Rare case of “cecal patch” in a child with left -sided ulcerative colitis.

Yan Bakman, 2011: Gastroenterology Res, 4(2): 58-63

Lesion: Cecal patch

Montreal and Paris classification for pediatric ulcerative colitis

UCEIS for assessment of UC activity

Walsh A, et al. Gastrointest. Endoscopy Clin. N. Am. 2014; 24: 367-378

Mark Samaan, 2014, A systematic review of UC clinical trials.

Vascular pattern (1 – 3): (A) 1, (B) 2, and (C) 3; Bleeding (1 – 4): (D) 1, (E) 2, (F) 3, and (G) 4; Erosions and ulcerations (1 – 4): (H) 1, (I) 2, (J) 3, and (K) 4.

Four grades:

• remission (0–1);

• mild (2–4);

• moderate (5–6);

• severe (7–8).

Management

•Multiple biopsies (2 or more per section) from rectum, sigmoid colon, descending colon, transverse colon, cecum, and ileum.

•Treatment:

–Aminosalicylates

–Corticosteroids

–Immunnomodulators, TNF-alpha blocking agents

–Surgery