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Indeterminate colitis: a pathologist's view.
1Academic Department of Pathology and CR-UK Colorectal Cancer Unit, St. Mark's Hospital, Northwick Park, Watford Road, Harrow HA1 3UJ, UK. i.talbot@doctors.org.uk
Summary
Indeterminate colitis is a provisional diagnosis. When all evidence is considered, it clinically resembles ulcerative colitis, impacting treatment and surgical decisions.
Area of Science:
- Gastroenterology
- Colorectal Surgery
Background:
- Indeterminate colitis is a provisional diagnosis used when differentiating between ulcerative colitis and Crohn's disease is initially unclear.
- Historically, based on pathology alone in fulminant colitis, some cases progressed to Crohn's disease.
Purpose of the Study:
- To clarify the clinical behavior of indeterminate colitis when all diagnostic information is considered.
- To assess the implications of this diagnosis for surgical management, particularly pouch surgery.
Main Methods:
- Review of clinical data and diagnostic evidence for patients with indeterminate colitis.
- Comparison of clinical presentation and progression of indeterminate colitis with established ulcerative colitis and Crohn's disease.
Main Results:
- When all available clinical and investigative evidence is utilized, indeterminate colitis presents clinically similar to ulcerative colitis.
- The initial definition based solely on pathology in fulminant colitis showed a subset progressing to Crohn's disease.
Conclusions:
- The clinical course of indeterminate colitis, when fully assessed, aligns with ulcerative colitis.
- This understanding has significant implications for patient management and surgical strategies, especially in pouch surgery for inflammatory bowel disease.