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Ulcerative Colitis : Clinical-I

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Ulcerative colitis (UC) may begin insidiously or with an acute attack requiring emergent attention. The attacks may last days, weeks, or months and are characterized by bloody diarrhea, stringy mucoid stools, and cramping abdominal pain which is often relieved by defecation. Most patients experience relapse within 10 years after diagnosis. About one-third require colectomy in the first 3 years.

Colectomy can relieve symptoms attributable to the intestinal disease; however, extra-intestinal manifestations continue. They include migratory polyarthritis, ankylosing spondylitis, sacroiliitis, uveitis, oral aphthous erosions, and skin manifestations (pyoderma gangrenosum, erythema nodosum). A small percentage of patients with UC develop liver disease which can take one of many forms (fatty liver, liver abscess, cirrhosis, sclerosing cholangitis, pericholangitis, and hepatocellular carcinoma).

This image is a close-up of the previous slide showing UC in a colectomy specimen. Note the abrupt transition to normal mucosa. The affected mucosa is hyperemic and shows numerous pseudopolyps.For detailed gross pathologic features of UC, go to slides 6-15. Image copyright: pathorama.ch

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