A woman complains of frequent, liquid stool (up to 9-10 times per day) with mucus and blood admixtures, dull pain in the hypogastrium, weight loss of 4 kg within the last year. Objectively: malnutrition, dry skin, low turgor, aphthous stomatitis. The stomach is soft, the sigmoid colon is spastic and painful on palpation. Occult blood test is positive. Fi-brocolonoscopy: edema, hyperemia, mucosal granulation, pseudopolyps, small ulcers with irregular edges. Make the diagnosis:

Answer options

1. Colon cancer
2. Crohn’s disease (regional enteritis)
3. Chronic enterocolitis
4. Irritable bowel syndrome
5. Nonspecific ulcerative colitis

Explanation

UC is a disease of the rectum and colon with extraintestinal manifestations (arthritis, sclerosing cholangitis, skin lesions – erythema nodosum and pyoderma gangrenosum, uveitis and episcleritis, aphthous stomatitis). Colonic inflammation is diffuse, confluent, and superficial, primarily affecting the mucosa and superficial submucosa. Severe disease corresponds to more than six bloody stools a day and evidence of systemic illness, with fever, tachycardia, anemia, and raised inflammatory markers. Hypoalbuminaemia is common and an ominous finding. Bailey & Love’s short practice of surgery. – 27th edition. – P. 1267.