Colitis ulcerosa - chronic active 3
This 26-year-old white female was first diagnosed with ulcerative colitis 8 years ago and has suffered recurrent disease flares and involvement of the entire colon and into the cecum. The patient was seen for a scheduled follow-up colonoscopy. Clinically, she reported few complaints, with 4-5 loose stools per day without admixture of blood.
The video shows the descending colon and sigmoid of a patient with chronic active ulcerative colitis. The mucosa is in general hyperplastic with innumerable small pseudopolyps. Haustration is completely lost in some segments and the bowel has the appearance of a stiff tube. Vessels are no longer recognizable. Between areas of hyperplastic tissue, there are numerous small ulcerations with whitish-yellow surfaces.
The duration of the disease and the endoscopic findings mean that a careful histological examination with stepped biopsies is essential, since the patient is at increased risk of developing malignant changes.
(see also commentary to example 1 and example 2).