¿Aún no está registrado?

Cree su cuenta. Regístrese en Elsevier y obtendrá: información relevante, máxima actualización y promociones exclusivas.

Registrarme ahora
Ayuda - - Regístrese - Teléfono 902 888 740
Buscar en

FI 2016

© Thomson Reuters, Journal Citation Reports, 2016

Indexada en:

SCIE/Journal of Citation Reports, Index Medicus/Medline, Excerpta Medica/EMBASE, SCOPUS, CANCERLIT, IBECS


  • Factor de Impacto: 0,917(2016)
  • 5-años Factor de Impacto: 0,791
  • SCImago Journal Rank (SJR):0,246
  • Source Normalized Impact per Paper (SNIP):0,264

© Thomson Reuters, Journal Citation Reports, 2016

Gastroenterol Hepatol 2003;26:64-9 - DOI: 10.1016/S0210-5705(03)79045-1
Colitis ulcerosa con afección segmentaria
Ulcerative colitis with segmental involvement
C. Dolz, , A. Vilella, H. Andreu, J. Riera
Servicio de Digestivo. Fundación Hospital Son Llàtzer. Palma de Mallorca. España
Recibido 03 abril 2002, Aceptado 29 agosto 2002

Ulcerative colitis is a chronic inflammatory disease affecting areas of the colon or the full length. From the endoscopic point of view, ulcerative colitis presents lesions that stretch continuously from the rectum to variable colon segments, a characteristic that is of great value when distinguishing it from Crohn's disease. Continuous involvement, without healthy patches, justifies ending endoscopic exploration once the distal end of the lesion has been reached.


To retrospectively study the frequency of segmental lesions in the colonoscopies performed in patients with ulcerative colitis.


Diagnosis of ulcerative colitis and proctitis was established by clinical, endoscopic, histologic, analytical, and radiological criteria. The indication and number of endoscopies was made on the basis of the clinical criteria of diagnosis, acute episodes, refractoriness or dysplasia screening. The extent of the examination also depended on clinical criteria: the severity of the episode, tolerance to colonoscopy or the degree of cleansing.


A total of 155 coloscopies were performed. In 113 colonoscopies (73%) the distal end of the lesion was reached and in 70 (45%) the cecum was reached. Of the 80 patients, 27 (33%) presented ulcerative proctitis at diagnosis. Nine of the 80 patients (11.3%) biopsies were performed in healthy colonic patches, which confirmed histological normality. Six of the 9 patients were receiving no treatment. In all patients except two, the cecum was reached in one or more of the colonoscopies. The distribution of the segmental lesions varied but these were mainly found in the periappendicular region and in the cecum in 6 of the 7 patients in whom the cecum was reached. Of the 80 patients, endoscopic evidence of rectal sparing was found in 5 (6.3%); of these, 4 were receiving systemic or topical treatment. Histological analysis confirmed the absence of inflammatory lesions in these patients. The only patient who was not receiving treatment presented microscopic lesions compatible with ulcerative colitis.


Endoscopic segmental lesions in ulcerative colitis were present in 11.3% of patients. Segmental lesions were most frequently found in the cecum and periappendicular region. Endoscopic and histologic evidence of rectal sparing may be the result of systemic or topical treatment.

El Texto completo solo está disponible en PDF
D.P. Jewel
Ulcerative colitis
Gastrointestinal disease 5th ed, pp. 1305-1330
R.C. Haggitt
Ulcerative colitis
Gastrointestinal pathology, pp. 325-355
W.J. Hogan,G.T. Hensley,J.E. Geenen
Endoscopic evaluation of inflammatory bowel disease
Med Clin North Am, 64 (1980), pp. 1083-1102
N. Oshitani,A. Kitano,S. Nakamura,A. Obata,H. Hashimura,M. Hiki
Clinical and prognostic features of rectal sparing in ulcerative colitis
Digestion, 42 (1989), pp. 39-43
C.N. Bernstein,F. Shanahan,P. Anton,W.N. Weinstein
Patchiness of mucosal inflammation in treated ulcerative colitis: a prospective study
Gastrointest Endosc, 42 (1995), pp. 232-237
B. Kim,J.L. Barnett,C.G. Kleer,H.D. Appelman
Endoscopic and histological patchiness in treated ulcerative colitis
Am J Gastroenterol, 94 (1999), pp. 3258-3262 http://dx.doi.org/10.1111/j.1572-0241.1999.01533.x
G. D'Haens,K. Geboes,M. Peeters,F. Baert,N. Ectors,P. Rutgeerts
Patchy cecal inflammation associated with distal ulcerative colitis. A prospective endoscopic study
Am J Gastroenterol, 92 (1997), pp. 1275-1279
I.S. Scott,M. Sheaff,A. Coumbe,R.M. Feakins,D.S. Rampton
Appendiceal inflammation in ulcerative colitis
Histopathology, 33 (1998), pp. 168-173
S.K. Yang,H.Y. Jung,G.H. Kang,Y.M. Kim,S.J. Myung,K.M. Shim
Appendiceal orifice inflammation as a skip lesion in ulcerative colitis: an analysis in relation to medical therapy and disease extent
Gastroentest Endosc, 49 (1999), pp. 743-747
R. Odze,D. Antonioli,M. Peppercorn,H. Goldman
Effect of topical 5-aminosalicylic acid (5-ASA) therapy on rectal mucosal biopsy morphology in chronic ulcerative colitis
Am J Surg Pathol, 17 (1993), pp. 869-875
J.R. Goldburn,H.D. Appelman
Appendiceal involvement in ulcerative colitis
Mod Pathol, 5 (1992), pp. 607-610
C.A. Spiliadis,C.A. Spiliadis,J.E. Leonard-Jones
Ulcerative colitis with rectal sparing of the rectum. Clinical features, histology and prognosis
Dis Colon Rectum, 30 (1987), pp. 334-336
C.G. Kleer,H.D. Appelman
Ulcerative colitis. Patterns of involvement in colorectal biopsies and changes with time
Am J Surg Pathol, 22 (1998), pp. 983-989
M.L. Mutinga,F.A. Farraye,H.H. Wang,R.D. Odze
Clinical significance of right colonic inflammation in patients with left sided chronic ulcerative colitis: a study of 34 patients
Abstract DDW, (2001),
W.B. Perry,F.G. Opelka,D. Smith,T.C. Hicks,A.E. Timmcke,J.B. Gathrigth
Discontinous appendiceal involvement in ulcerative colitis: pathology and clinical correlation
J Gastrointest Surg, 3 (1999), pp. 141-144
S.H. Kroft,S.J. Stryker,M.S. Rao
Appendiceal involvement as a skip lesion in ulcerative colitis
Mod Pathol, 7 (1994), pp. 912-914
P. Rutgeerts,G. D'Haens,M. Hiele,K. Geboes,G. Vantrappen
Appendicectomy protects againts ulcerative colitis
Gastroenterology, 106 (1994), pp. 1251-1253
K. Okawa,H. Oiya,T. Aoki,S. Harihara
Appendiceal lesion in ulcerative colitis
Nippon Rinsho, 57 (1999), pp. 2584-2589
K. Okazaki,H. Onodera,N. Wanatabe
A patient with improvement of ulcerative colitis after appendicectomy
Gastroenterology, 119 (2000), pp. 502-506
C. Bernstein,F. Shanahan,W. Weinstein
Histological patchiness and sparing of the rectum in ulcerative colitis: refuting de dogma
J Clin Pathol, 50 (1997), pp. 354-355
T.S. Levine,M. Tzardi,S. Mitchell,C. Sowter,A.B. Price
Diagnostic difficulty arising from rectal recovery in ulcerative colitis
J Clin Pathol, 49 (1996), pp. 319-323
J. Markowitz,E. Hahn,K. Grancher,J. Hyams,W. Treem,F. Daum
Atypical rectosigmoid histology in children with newly diagnosed ulcerative colitis
Am J Gastroenterol, 88 (1993), pp. 2034-2037
A.M. Zaitoun,I. Cobden,H.A. Mardini,C.O. Record
Morphometric studies in rectal biopsy specimens from patients with ulcerative colitis: effect or oral 5-aminosalicylic acid and rectal prednisolone treatment
Gut, 32 (1991), pp. 183-187
Correspondencia: Jefe de Unidad de Aparato Digestivo. Fundación Hospital Son Llatzer. Carretrera Manacor, km. 4. 07198 Palma de Mallorca. España.
Copyright © 2003. Elsevier Espa??a, S.L.