Fibercolonoscopy for the diagnosis of granulomatous colitis

In order to clarify the significance of fibercolonoscopy in diagnosis of granulomatous colitis, the pathological, radiological, endoscopic and clinical differences between granulomatous colitis and ulcerative colitis were investigated on 12 cases of granulomatous colitis and 23 cases of ulcerative colitis, which underwent colonic resections between 1954 and 1973. The comparative studies have revealed considerable differences in their characteristic features besides the overlapping spectrum. As a consequence of assessments made of the various diagnostic techniques as to usefulness in differential diagnosis between the two colitis conditions, it was noted that fibercolonoscopy and biopsy under direct vision, when applied in conjunction with the conventional procedures, readily facilitate the differential diagnosis without any surgical intervention in all aspects, excepting the depth of inflammatory involvement and the presence of lymphangiectasia. However, the depth of the inflammed lesion as well as lymphangiectasia can also be estimated indirectly. Therefore, it seems that it is possible to make the differential diagnosis between the two colitis conditions even prior to colectomy, with the exception of atypical forms which represent overlapping findings.