Clinical Symptoms And Endoscopic Analysis Of 54 Ulcerative Colitis Cases

Background and aims: Ulcerative colitis (UC) belongs to inflammatory bowel disease (IBD), of which etiology and pathogenesis is not totally understood to date. According to a series of recent evidence, the incidence is going up gradually in the Asian Pacific region, and the number of cases in our country increased by 3.08 times over the past 10 years. Having diversified clinical symptom, the proper diagnosis depends on clinical symptoms, features of colonoscopy and biopsy histology findings and X-rays, in which colonoscopy and and biopsy histology findings plays an important role, also demonstrating its value in differential diagnosis. We retrospectively analyse the clinical manifestation and colonoscopy findings of 54 cases of UC patients, in order to improve the accuracy of diagnosis.Methods: 54 patients of the Third People's Hospital of Zhengzhou, Henan province, diagnosed as ulcerative colitis from 2000 to 2005, were enrolled. Depending on the 2000 Chengdu (China) Conference, the diagnosis criteria of ulcerative colitis was according to the clinical features, colonoscopy and the histology of mucosal biopsy. Retrospectively analyze the clinical symptoms and the features of colonoscopy and histology in UC patients.Results: In the 1376 patients accepting colonoscopy examination from January, 2000 to December, 2005, the proportion of 54 patients diagnosed as UC was 3.92%. The ratio of male to female was 1.08:1. The mean age at the diagnosis was 46.6 years old, the common ages ranged from 30 to 59 years old, and the peak ages were from 40 to 49 years old. The typical clinical symptom of UC were diarrhea, bloody purulent stool and abdominal pain, showing few extra intestinal manifestations and severe complications. Inflammation in 50 UC cases (92.2%) mainly scattered in the left-sided colons, among which proctitis or proctosigmoiditis was found in 37 (68.5%) cases. Endoscopic features included diffused congestive edema of intestinal mucosa, or widespread erythema, erosion and ulceration, the ratio of which was 88.9%, 66.1%, respectively. Histological manifestations showed massive inflammatory cells infiltration in mucosa and submucosa, cryptitis, crypt abscess, erosion and ulceration. There was a case developing colon cancer, two cases moderate to severe atypical hyperplasia.Conclusions: The common incidence ages of ulcerative colitis range from 30 to 59 years old, and peak ages from 40 to 49 years old. The ratio of male to female is corresponding. The major symptoms of UC are diarrhea, bloody purulent stool and abdominal pain, showing few extraintestinal manifestations and severe complications. The lesions of UC are commonly located in the rectum, sigmoid colon and the left side colon, and endoscopic features included diffused congestive edema of intestinal mucosa, or widespread erythema, erosion and ulceration. Colonoscopy with histological manifestations is the very major means for the diagnosis of ulcerative colitis.