Table 2

Discontinuous changes in ulcerative colitis

New or longstanding ulcerative colitisCaecal ‘patch’ (EL1a RGA)No disease in adjacent colon.
Changes resemble those seen distally
Patch may also involve ascending colon
Consider the possibility of Crohn's disease
39 41–45
Rectal sparing (EL1a RGA)Consider the possibility of Crohn's disease3 28 38–40
Appendiceal ‘ulcerative colitis’ (EL1a RGA)Not uncommon
Changes may resemble colorectal features
Not seen in biopsies
Fulminant ulcerative colitisCan be segmental (EL1a RGA)Discontinuous between sites11 17 39 45–47
Longstanding ulcerative colitisDiscontinuous or patchy distribution of inflammation and crypt abnormalitiesVariability between and within sites
Therapy may be partly or wholly responsible
3 17 42 45