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Published on: September 22, 2019
Evolution of collagenous colitis into severe and extensive ulcerative colitis
Hugh J Freeman1, Ken W Berean, Michael Nimmo
1Department of Medicine, University of British Columbia, Vancouver, Canada. hugfree@shaw.ca
Summary
Collagenous colitis can rarely lead to severe pancolitis refractory to treatment. This case highlights the need for long-term patient monitoring for serious colonic complications.
Area of Science:
- Gastroenterology
- Colorectal Surgery
Background:
- Collagenous colitis is a colonic inflammatory disorder characterized by a thickened subepithelial collagen layer.
- While typically benign, collagenous colitis can present with serious complications.
Observation:
- A 69-year-old woman with collagenous colitis developed refractory bloody diarrhea.
- Endoscopic and histopathological findings revealed a progressing neutrophilic inflammatory process.
Findings:
- The patient's condition evolved into a diffuse, extensive pancolitis.
- Total proctocolectomy was ultimately required, with no evidence of persistent collagenous colitis in the resected specimen.
Implications:
- This case underscores the necessity of long-term surveillance for patients diagnosed with collagenous colitis.
- Superimposed colonic complications, such as severe pancolitis, may necessitate aggressive interventions like proctocolectomy.
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