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Image Description

Due to the increased risk of dysplasia and malignancy, patients with ulcerative colitis are put under surveillance protocols for early detection. Surveillance colonoscopies are begun 8 years after the initial diagnosis or at the time of diagnosis if they also have coexistent primary sclerosing cholangitis. Colonoscopies are performed every 1-2 years, preferably during inactive phase of the disease.

Four-quadrant biopsies are performed every 10 cm throughout the colon. In addition, targeted biopsies from any raised or suspicious areas are taken. The image shows a tubular adenoma-like focus in a patient with ulcerative colitis. A large crypt abscess is present near the right edge of the image. See next slide for terminology used in describing dysplasia in the setting of inflammatory bowel disease.

Image 34 of 60