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Ulcerative Colitis : Gross Pathology

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This colectomy specimen shows ulcerative colitis (UC) during quiescent stages. There is no ulceration, mucosal hyperemia or hemorrhage. The mucosa appears almost normal with mild granularity and some scarring. In some cases, the mucosa is atrophic and smooth and lacks normal folds. Submucosal fat content may be excessive. Unlike Crohn disease, mural thickening does not occur and serosal surface is uninvolved.

In advanced cases of UC, the repeated cycles of exacerbations and remissions with healing lead to fibrosis with narrowing and shortening of the entire large bowel. In patients who undergo ileostomy or colostomy, the colon atrophies over time with extreme narrowing of the lumen and increase in pericolic fat. Image copyright: pathorama.ch

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