A CASE OF ULCERATIVE COLITIS DIAGNOSED ONLY AFTER COMPREHENSIVE EVALUATION OF FOLLOW-UP STUDY

—A UNIQUE RESPONSE TO TREATMENT—

Abstract

In all diseases, the clinical stage inf luenses a difficulty in diagnosis. The same situation is observed in nonspecific colitis and a number of patients of ulcerative colitis are indis-tinguishable from Crohn's disease of the large bowel especially in relatively early stage. A patient was a 39-year-old man with chief complaints of diarrhea, fever and melena. At first colonofiberscopy showed an aphthoid ulcer on the sigmoidal mucosa and also from the histological findings of biopsy specimen the Crohn's disease was suspected. But the disease progressed to cover the entire colon after the lapse of a few months and ultimately this patient's colitis was diagnosed to be an ulcerative colitis. Meanwhile the symptoms improved dramtically by the use of choromycetin but no evidence of bacterial infection was found. It should be stressed that the differentiation of nonspecific colitis had to be made after comprehensive evaluation of the findings such as follows: 1) clinical manifestations, 2) radiological and endoscopic features, 3) histological findings of biopsy specimens, 4) clinical course.