Ulcerative colitis - rectal fistula
This 21-year-old white female has suffered from ulcerative colitis for a little over a year. The disease began with severe pain on defecation with simultaneous appearance of loose stools with admixture of blood and pus. Since then, despite adequate treatment, remission has never been attained. The current examination is being done to evaluate a previously diagnosed fistula.
The video begins in the sigmoid colon and shows a mucosa that is covered with fibrin and purulent material. The mucosa is very vulnerable and vascular structure is not visible. Between the areas of deposit, there are areas of spontaneous bleeding. Immediately proximal to the anal canal is a nearly non-inflamed fistular opening.
When fistulae are found, one must always think about Crohn's disease. In this case, however, both macroscopic findings and histology confirmed ulcerative colitis.