Pediatric Ulcerative Colitis

  • Etiology: idiopathic inflammatory bowel disease that is superficial in nature extending from rectum to proximal colon in a contiguous manner
  • BE: superficial bowel wall inflammation limited to colon and rectum, see pseudopolyps in end stage which are areas of normal mucosa surrounded by denuded ulcerated mucosa
  • US: thickening of cecum, bowel wall hyperemia, prominence of submucosa with preservation of layered structure of bowel wall which may be lost in advanced disease
  • Clinical: endoscopically visible as it affects the colon, surgery usually curative

Radiology Cases of Ulcerative Colitis

BE of ulcerative colitis
AP spot image of the rectosigmoid colon from a barium enema shows multiple fine mucosal ulcerations.
BE of ulcerative colitis
AXR AP from a barium enema (left) shows the loss of haustral markings in the colon (lead pipe sign). The magnified view (right) suggests the presence of multiple fine mucosal ulcerations.
Enema of pseudopolyps in ulcerative colitis
AP AXR (left) and magnified AP spot image of the splenic flexure (right) from a double contrast barium enema shows a large number of small polypoid lesions throughout the colon with the space between the polyps appearing to be denuded and ulcerated.

Gross Pathology Cases of Ulcerative Colitis

Pathological image of colonic pseudopolyps in ulcerative colitis
Pathological image of the colon shows colonic pseudopolyps.
Gross pathological image of ulcerative colitis
Gross pathological image of the sectioned colon shows colonic pseudopolyps throughout the length of the colon.