1. Diagnosis of Colitis: Making the Initial Diagnosis
Maria T. Abreu, Noam Harpaz 
Clinical Gastroenterology and Hepatology 
Volume 5, Issue 3, Pages (March 2007)
DOI: /j.cgh
Copyright © 2007 AGA Institute Terms and Conditions

2. Figure 1
(A) Patient’s endoscopic findings characterized by diffuse superficial ulcerations and exudates. (B) Biopsy revealing typical pattern of acute infectious colitis characterized by edema and infiltration by neutrophils. The crypts are separated from one another and from the muscularis mucosae by edema, but their architecture is preserved, and there is no significant increase in lymphocytes and plasma cells.
Clinical Gastroenterology and Hepatology 2007 5, DOI: ( /j.cgh )
Copyright © 2007 AGA Institute Terms and Conditions

3. Figure 2
(A) Pseudomembranous colitis is evident on repeat endoscopy. (B) Biopsy showing superficial necrosis, dilated crypts, and eruptive inflammatory exudates.
Clinical Gastroenterology and Hepatology 2007 5, DOI: ( /j.cgh )
Copyright © 2007 AGA Institute Terms and Conditions

4. Figure 3
(A) Normal rectal mucosa with muciphages separating the crypt bases from the muscularis mucosae. This should not be interpreted as postinflammatory “crypt shortfall” as seen in IBD. (B) Focal active colitis. This nonspecific pattern occurs in resolving infectious colitis, Crohn’s disease, and after phosphosoda administration among other conditions. (C) Ulcerative colitis of recent onset characterized by full-thickness lymphoplasmacytic infiltrates, crypt shortfall, and selective neutrophil infiltration of the crypts. Focal branching of a crypt is noted in the lower right, but the degree of crypt disarray often seen in chronic IBD is not evident. (D) Chronic infectious colitis. In addition to mild edema and dense neutrophil infiltration, the lamina propria also contains mononuclear inflammatory cells surrounding the crypt bases. (E) Acute colonic ischemia. The crypts are devoid of goblet cells and taper toward the surface. The lamina propria is densely eosinophilic, and neutrophils are less abundant than in infections. (F) Colitis associated with E coli O157:H7. The edema, neutrophil infiltrates, and preserved crypt architecture resemble the findings in conventional acute infectious colitis. However, the diagnosis was suggested by the presence of an inflammatory pseudomembrane and evidence of ischemia in an adjoining biopsy. (G) CMV inclusion body in biopsy of a patient with ulcerative colitis on an immunosuppressive regimen. (Inset) High magnification.
Clinical Gastroenterology and Hepatology 2007 5, DOI: ( /j.cgh )
Copyright © 2007 AGA Institute Terms and Conditions