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The Pathological Basis of the Radiological Changes in Ulcerative Colitis

Addenbrooke's Hospital, Cambridge

This excerpt was created in the absence of an abstract.

In ten cases of ulcerative colitis treated by colectomy, the pathological findings in the excised colon have been compared with the findings on barium enema immediately before colectomy, and with the appearance of the barium-filled excised colons.

The absence of mucosal haustra was associated with fairly severe submucosal damage.

The presence of narrowing was associated with fairly severe submucosal fibrosis, although the converse was not true.

A smooth contour may be associated with a normal or abnormal mucosa. The presence of abnormality is indicated by an abnormal after-evacuation surface pattern or, in the presence of more severe damage, absence of mucosal haustra and alteration in calibre.

The presence of indentations, particularly when associated with a reticular surface pattern, usually indicated areas of mucosal denudation, between remaining islands of inflamed mucosa, with or without small pseudopolyps. The same appearance may be associated with deeper ulcers into the muscular coat.

Large pseudopolyps produced translucencies in the barium-filled enema and a honeycomb surface pattern after evacuation.

Double contour was associated with the presence of acute inflammation with areas of denuded mucosa, the ulceration undermining the edge of remaining mucosal islands.

Comparison of the findings on barium-filled excised colons, which have been washed through beforehand, suggests that the mucosal changes seen in the barium enema contour are masked to a varying but appreciable extent by the presence of debris and are often more severe than the barium enema appearances would suggest.

Received for publication March 1, 1959.