Ulcerative Colitis

Clinical manifestations: chronic diarrhea, frequently bloody; anemia, rarely pain

Diagnosis “Ulcerative Colitis”":
x Sonography
x High colonoscopy with ileoscopy and tissue sampling from all bowel segments, also to exclude carcinoma in long-standing cases; rectal biopsy is particularly advised (for positive differentiation from Crohn disease)
x Gastroduodenoscopy may also be done if necessary.
x Radiography: double-contrast enema is necessary only if endoscopy cannot be done.

Sonographic findings “Ulcerative Colitis”:
XContinuous pattern of intestinal involvement, usually confined to the rectum, sigmoid colon, and descending colon
x Less commonly, there may be detectable wall thickening to a maximum of 8mm (not as pronounced as in Crohn disease); wall thickness apparently correlates with the activity of the disease.
x Irregular hypoechoic or echogenic intraluminal wall indicating pseudopolyp formation
x Scans in long-standing cases show a rigid tube devoid of haustrations.
x Complication: toxic megacolon

Accuracy of sonographic diagnosis “Ulcerative Colitis” : The sonographic signs may also appear in infectious bowel diseases, so it is important to proceed with endoscopic examination and biopsy.