PMC6501135_01
Representative endoscopy images: (a). Initial ileoscopy showing erythematous, edematous friable mucosa with the presence of spontaneous bleeding. (b). Follow-up ileoscopy demonstrating normal looking mucosa after 5 months of vedolizumab therapy.
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Two months later a follow-up endoscopy showed progression of inflammatory changes:diffuse edematous inflamed mucosa with small superficial aphthous-like lesions and superficial bleeding visible within the whole examined ileum [Figure 1(a)]. However, the next endoscopy scheduled ten weeks later revealed significant endoscopic improvement [Figures 1(b) and 2(b)].
Representative histology sections of the ileum. The biopsy specimen before the treatment (a) reveals villous architectural distortion and a combination of acute and chronic abundant inflammation of the lamina propria. The inflammation consists of neutrophils, plasma cells, and lymphocytes. After 5 months of vedolizumab therapy (b), stromal oedema, and hyperaemia only a few lymphocytes and plasma cells in the lamina propria are visible.
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The pathology specimen showed typical features of UC [Figure 2(a)].
Representative endoscopy image of rectum and ileorectal anastomosis with swelling changes, congestion, and numerous aft-like loss of mucous membrane.
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An endoscopy revealed active mucosal inflammation within the ileum, ileorectal anastomosis, and also rectal stump [Figure 3].