Case scenario: ULCERATIVE COLITIS ( Extensive ulcerative colitis)  admitted to hospital for rehydration and further investigations.

 No conclusive diagnosis was made

Patient profile
Currently:
 22 years old
 Female  Patient is passing 10-20 liquid stools per day.
 CC: presented to the surgery department , with a two month history  Diarrhoea is mucoid and bloody. Occurs day and night.
of severe abdominal cramps, persistent bloody and mucoid  Patient complains of malaise, lethargy and anorexia. She has lost 8
diarrhoea, weight loss and tiredness kg in the past 2 months.
History Family Hx:
2 months ago  Mother – type 2 Diabetes Mellitus
 abdominal cramps and intense urge to pass stool every after meal Lab Reports:
 passage of stool becoming more frequent
 Increased WBC and platelets production and decreased protein
 two days she was passing persistently watery diarrhoea mixed with
fresh blood and mucous Colonoscopy Report: - Very friable mucosa. Extensive ulceration with
 One week later she collapsed at home pseudopolyps, involving the rectum, entire sigmoid and left colon up to the
transverse colon.
1 month ago
Histological Findings: Pathology is limited to the mucosa and submucosa.
 Symptoms persisted
Intense infiltration of the mucosa and submucosa with neutrophils and crypt
 experienced diarrhoea and vomiting after eating or drinking, which
abscesses, lamina propria with lymphoid aggregates, plasma cells, mast cells
lasted for 10 days.
and eosinophils, and shortening and branching of the crypts

ULCERATIVE COLITIS

- an inflammatory disease of the large intestine wherein ulcers form in the mucosa and submucosa layers of the colon and rectum

Etiology:

- Autoimmune condition
- Inflammatory reaction
- Idiopathic
 Modifiable factors Non-modifiable factors

There is no modifiable factor  Age: 22

noted in patient profile.  Gender: Female

Injury of sub mucosa and mucosa

Inflammation of GIT epithelial lining

Alterated cell Infection at the anus

Inc permeability
function
of blood vessels in
Malabsorption of Formation of GIT
water and Presence of bacteria
ulcers
nutrients in rectal lining.
Inc fluid leak out in
GIT
Diarrhea is Release of blood Anal irritation
bloody and in lining
mucoid Inflamed GIT
lumen Tenesmus
Activation of WBC

Iron
Released
fluid loss Electrolytes
deficiency Bowel obstruction
production of
imbalance neutrophils
Hematochezia
and
eosinophils Vomitting
Weight loss
Dec
Decreased Hemoglobin
appetite Release of
Prostaglandin
Lethargy
Tiredness
Anorexia Malaise Abdominal
cramps