Ulcerative colitis: Difference between revisions
(Created page with "==Background== *Inflammation tends to be progressively more severe from proximal to distal colon *Rectum is almost always involved *Peak incidence occurs in second and third deca...") |
|||
| Line 23: | Line 23: | ||
==Work-Up== | ==Work-Up== | ||
*Labs | |||
**CBC | |||
**Chemistry | |||
*Imaging | |||
**?Abd x-ray | |||
**?CT A/P | |||
==DDx== | ==DDx== | ||
Revision as of 05:21, 30 July 2011
Background
- Inflammation tends to be progressively more severe from proximal to distal colon
- Rectum is almost always involved
- Peak incidence occurs in second and third decades of life
Diagnosis
- Abdominal cramps and diarrhea (often bloody)
- Classification
- Mild
- <4 BM/d
- No systemic symptoms
- Few extraintestinal manifestaions
- Occasional constipation and rectal bleeding
- Moderate
- Colitis extends to splenic flexure
- Severe
- Frequent BM
- Anemia
- Fever
- Wt loss
- Frequent extraintestinal manifestations
- Pancolitis
- Mild
Work-Up
- Labs
- CBC
- Chemistry
- Imaging
- ?Abd x-ray
- ?CT A/P
DDx
- Infectious colitis
- Crohn's colitis
- Ischemic colitis
- Toxic colitis (antineoplastic agents)
- Pseudomembranous colitis
- Gonococcal proctitis
Treatment
- Rule-out complications
- Hemorrhage
- Toxic megacolon
- Develops in advanced disease when all the layers of the colon become involved
- Presentation
- Severely ill
- Abd distended, tender, peritonitic
- Fever, tachycardia
- Leukocytosis (may be masked if pt taking steroids)
- Perforation results in high mortality
- Abd x-ray: Long, continuous segment of air-filled colon >6cm in diameter
- Perirectal fistula
- Perirectal abscess
- Obstruction (due to stricture)
- Carcinoma
Disposition
See Also
Source
Tintinalli