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Published on: October 17, 2013
Benign and malignant colorectal strictures in ulcerative colitis
V Gumaste1, D B Sachar, A J Greenstein
1Department of Medicine, Mount Sinai School of Medicine, City University of New York, NY.
Gut
|July 1, 1992
Summary
Malignant colorectal strictures in ulcerative colitis are often diagnosed late in the disease course, proximal to the splenic flexure, and present with bowel obstruction. These factors significantly increase the likelihood of malignancy.
Area of Science:
- Gastroenterology
- Oncology
- Colorectal Surgery
Background:
- Colorectal strictures are a known complication of ulcerative colitis.
- Distinguishing benign from malignant strictures is crucial for patient management.
Purpose of the Study:
- To identify key features differentiating malignant from benign colorectal strictures in ulcerative colitis patients.
- To assess the stage of colorectal cancer associated with strictures.
Main Methods:
- Retrospective analysis of 1156 ulcerative colitis patients admitted between 1959 and 1983.
- Review of 70 colorectal strictures, categorizing them as benign or malignant.
- Comparison of clinical and pathological features between malignant and benign strictures.
Main Results:
- 17 of 70 strictures (24%) were malignant; 53 were benign.
- Malignant strictures were more likely to appear late in ulcerative colitis (after 20 years), located proximally to the splenic flexure, and associated with symptomatic bowel obstruction.
- Colorectal cancer associated with strictures was more advanced (76% Stage D) compared to non-stricture-associated cancers.
Conclusions:
- Late disease onset, proximal location, and bowel obstruction are strong indicators of malignancy in ulcerative colitis-associated colorectal strictures.
- Stricture-associated colorectal cancers tend to be diagnosed at later stages, emphasizing the need for vigilant monitoring.
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