Endorectal ultrasound in infectious colitis may predict development of chronic colitis

In a previous study, we have shown that rectal endoscopic ultrasound (EUS) could be used to differentiate ulcerative colitis from Crohn's disease by demonstrating the presence of pathological lymph nodes around the rectum and sigmoid colon which were characteristic of ulcerative colitis. The aim of the present study was to evaluate the endosonographic features of infectious colitis and their potential clinical relevance.

We carried out rectal endosonography in 17 patients with infectious colitis of various etiologies. Wall features and perirectal lymph nodes were documented systematically.

In 15 patients no pathological lymph nodes were seen and the EUS wall features were also normal. In two patients where EUS showed pathological lymph nodes, follow-up confirmed ulcerative colitis several weeks later.

This preliminary study suggests that, in patients with infectious colitis, EUS may be able to suggest the diagnosis of associated ulcerative colitis; further studies with larger patient numbers are necessary.