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Right-sided ulcerative colitis

M Okada1, K Maeda, T Yao

  • 1First Department of Internal Medicine, School of Medicine, Fukuoka University, Japan.

Journal of Gastroenterology
|October 1, 1996
PubMed
Summary
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This case study details a rare instance of right-sided ulcerative colitis, a chronic inflammatory bowel disease, affecting only the right colon. Long-term follow-up confirmed the diagnosis, excluding other conditions.

Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Colorectal Surgery

Background:

  • Ulcerative colitis (UC) typically affects the colon symmetrically, often involving the rectum.
  • Right-sided UC presents a distinct pattern, posing diagnostic challenges.

Observation:

  • A patient presented with segmental, right-sided ulcerative colitis characterized by shallow ulcers, erosions, and luminal stenosis from the ascending colon to the cecum.
  • A skip lesion of superficial erosions was noted in the transverse colon, with the rectum and left colon spared initially.
  • Biopsies revealed non-specific inflammation in affected areas, with normal findings in the rectum and sigmoid colon.

Findings:

  • A comprehensive 5-year follow-up using radiography and endoscopy confirmed the diagnosis of right-sided UC.

Related Experiment Videos

  • Differential diagnoses including Crohn's disease, tuberculosis, Yersiniosis, Behçet's disease, and ischemic colitis were systematically excluded based on clinical, endoscopic, and histological data.
  • This case represents the first documented long-term follow-up of right-sided ulcerative colitis.

    • Implications:

    • Highlights the importance of long-term monitoring in diagnosing and managing atypical UC presentations.
    • Contributes to understanding the spectrum of ulcerative colitis and its segmental manifestations.
    • Informs clinical practice regarding the differential diagnosis of right-sided colonic inflammation.