PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of jclinpathJournal of Clinical PathologyVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
 
J Clin Pathol. 1978 June; 31(6): 567–577.
PMCID: PMC1145346

Overlap in the spectrum of non-specific inflammatory bowel disease--'colitis indeterminate'.

Abstract

It is stated that 10-20% of cases of non-specific inflammatory bowel disease cannot be classified. Thirty such cases, designated colitis indeterminate at the time of colectomy, were identified from the pathology files of St. Mark's Hospital. The Histopathological features of the surgical specimens and any available biopsy specimens were studied. In nearly all the cases urgent surgery had been required and the features of incipient or established fulminating disease were present. The pathology of these cases of Crohn's disease and ulcerative colitis overlapped, and differentiating features were scant or unreliable. Accepted criteria of Crohn's disease--namely, fissuring ulceration, transmural inflammation, and a maintained goblet-cell population--were found in cases subsequently proved to be ulcerative colitis. Disease activity greatly affected the evaluation of morphological features. Many of the difficulties were resolved when biopsy material obtained during a quiescent phase was examined. The specimens gave a dynamic perspective of the disease process, often more valuable than the static, non-specific picture of acute disease seen in the surgical specimens. Case of colitis indeterminate form a small distinctive group in the spectrum of inflammatory bowel disease which is characterised by a common pattern of pathology that presents a diagnostic dilemma.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (4.2M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Cook MG, Dixon MF. An analysis of the reliability of detection and diagnostic value of various pathological features in Crohn's disease and ulcerative colitis. Gut. 1973 Apr;14(4):255–262. [PMC free article] [PubMed]
  • Farmer RG, Hawk WA, Turnbull RB., Jr Regional enteritis of the colon: a clinical and pathologic comparison with ulcerative colitis. Am J Dig Dis. 1968 Jun;13(6):501–514. [PubMed]
  • Glass RE, Baker WN. Role of the granuloma in recurrent Crohn's disease. Gut. 1976 Jan;17(1):75–77. [PMC free article] [PubMed]
  • Glotzer DJ, Gardner RC, Goldman H, Hinrichs HR, Rosen H, Zetzel L. Comparative features and course of ulcerative and granulomatous colitis. N Engl J Med. 1970 Mar 12;282(11):582–587. [PubMed]
  • Hawk WA, Turnbull RB., Jr Primary ulcerative disease of the colon. Gastroenterology. 1966 Nov;51(5):802–805. [PubMed]
  • Jones JH, Lennard-Jones JE, Morson BC, Chapman M, Sackin MJ, Sneath PH, Spicer CC, Card WI. Numerical taxonomy and discriminant analysis applied to non-specific colitis. Q J Med. 1973 Oct;42(168):715–732. [PubMed]
  • Kent TH, Ammon RK, DenBesten L. Differentiation of ulcerative colitis and regional enteritis of colon. Arch Pathol. 1970 Jan;89(1):20–29. [PubMed]
  • Lennard-Jones JE, Lockhart-Mummery HE, Morson BC. Clinical and pathological differentiation of Crohn's disease and proctocolitis. Gastroenterology. 1968 Jun;54(6):1162–1170. [PubMed]
  • LOCKHART-MUMMERY HE, MORSON BC. Crohn's disease (regional enteritis) of the large intestine and its distinction from ulcerative colitis. Gut. 1960 Jun;1:87–105. [PMC free article] [PubMed]
  • LOCKHART-MUMMERY HE, MORSON BC. CROHN'S DISEASE OF THE LARGE INTESTINE. Gut. 1964 Dec;5:493–509. [PMC free article] [PubMed]
  • LUMB G, PROTHEROE RH, RAMSAY GS. Ulcerative colitis with dilatation of the colon. Br J Surg. 1955 Sep;43(178):182–188. [PubMed]
  • McGovern VJ, Goulston SJ. Crohn's disease of the colon. Gut. 1968 Apr;9(2):164–176. [PMC free article] [PubMed]
  • Margulis AR, Goldberg HI, Lawson TL, Montgomery CK, Rambo ON, Noonan CD, Amberg JR. The overlapping spectrum of ulcerative and granulomatous colitis: a roentgenographic-pathologic study. Am J Roentgenol Radium Ther Nucl Med. 1971 Oct;113(2):325–334. [PubMed]
  • Norland CC, Kirsner JB. Toxic dilatation of colon (toxic megacolon): etiology, treatment and prognosis in 42 patients. Medicine (Baltimore) 1969 May;48(3):229–250. [PubMed]
  • Price AB, Morson BC. Inflammatory bowel disease: the surgical pathology of Crohn's disease and ulcerative colitis. Hum Pathol. 1975 Jan;6(1):7–29. [PubMed]
  • Ritchie JK. Results of surgery for inflammatory bowel disease: a further survey of one hospital region. Br Med J. 1974 Feb 16;1(5902):264–268. [PMC free article] [PubMed]
  • ROTH JL, VALDES-DAPENA A, STEIN GN, BOCKUS HL. Toxic megacolon in ulcerative colitis. Gastroenterology. 1959 Sep;37:239–255. [PubMed]
  • Schachter H, Goldstein MJ, Rappaport H, Fennessy JJ, Kirsner JB. Ulcerative and "granulomatous" colitis--validity of differential diagnostic criteria. A study of 100 patients treated by total colectomy. Ann Intern Med. 1970 Jun;72(6):841–851. [PubMed]
  • Schachter H, Kirsner JB. Definitions of inflammatory bowel disease of unknown etiology. Gastroenterology. 1975 Mar;68(3):591–600. [PubMed]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Group