内科学-结肠炎PPT.ppt

COLONSCOPY COLONSCOPY COLONSCOPY COLONSCOPY LABORATORY FINDINGS Radiography ☆ Collar-button ulcers ☆ Nodular/ filiform ☆ Granularity of mucosa ☆ Disappear of the hastral markings RADIOGRAPHY RADIOGRAPHY DIAGNOSIS The diagnosis of ulcerative colitis is based on clinical features, laboratory tests, and endoscopic and histologic features. How UC is Diagnosed Clinical history Physical examination Lab tests Endoscopy(Colonoscopy) X-ray Tissue biopsy(Pathology) DIFFERENTIAL DIAGNOSIS Infectious colitis Crohn’s disease Colon cancer Irritable bowel syndrome Ischemic colitis Radiation colitis Diverticulitis DIFFERENTIAL DIAGNOSIS ulcerative colitis Crohn’s disease Site Rectum always Any segment of the colon only gastrointestinal tract Pattern Continuous Skip Diarrhea Bloody Usually nonbloody Fistula No Yes Endoscopic Erythema, friable, Aphthoid ulcers, deep findings superficial ulcerations ulcers Histologic Crypt abscess Granulomas (30%) features TREATMENT General therapy ☆ Nutrition ☆ Antidiarrheal medications ☆ Antibiotics Drug therapy ☆ Sulfalazine (SASP) ☆ 5-aminosalicylic (5-ASA) ☆ Corticosteroids ☆ Immunosuppressive agents TREATMENT Surgical treatment ☆ Emergent operation ☆ Selective operation Future therapy ULCERATIVE COLITIS DEFINITION Ulcerative colitis is a chronic disease characterized by inflammation of the mucosa and submucosa of the large intestine. The main clinical manifestations include diarrhea, abdominal pain. The incidence and prevalence of the disease vary greatly with geographic location. EPIDEMIOLOGY Rates are highest in northern climates and in well developed areas of the world Bimodal age distribution 15-40 and 50-80