PMC5491809_01
Colonoscopic images in the rectum (A), sigmoid colon (B), transverse colon (C), and descending colon (D, E) on admission. Colonoscopy revealed the exacerbation of ulcerative colitis in the rectum (A) and sigmoid colon (B). Although there were no active findings from the cecum to the transverse colon (C), we found long luminal edematous swelling and multifocal massive discharge of pus throughout the descending colon (D, E). The mucosa of the descending colon appeared to be nearly intact.
1349-7235-56-1157-g001.jpg
PMC5491809_01_1349-7235-56-1157-g001.jpg
g001
Colonoscopy on admission revealed widespread shallow ulcers in the rectum and coarse mucosa with mucous, pus, and blood in the sigmoid colon (Fig. 1A and B). Although there were no active UC findings from the cecum (terminal ileum) to the splenic flexure (Fig. 1C), we found long luminal edematous swelling and multifocal discharge of pus throughout the descending colon (Fig. 1D and E).
A computed tomography scan immediately after the colonoscopy (A, B). The scan showed a diffusely thickened wall with a narrowed lumen and intramural air-filled abscess cavities and multifocal low-density areas of abscesses within the wall of the descending colon. The arrows and arrowheads indicate the lumen of the descending colon and air-filled abscess cavities, respectively.
1349-7235-56-1157-g002.jpg
PMC5491809_01_1349-7235-56-1157-g002.jpg
g002
Computed tomography immediately after colonoscopy showed a diffusely thickened wall with a narrowed lumen and intramural air-filled abscess cavities and multifocal low-density areas of abscesses (Fig. 2), particularly within the wall of the descending colon.
Colonoscopic images in the sigmoid colon (A) and descending colon (B) and a computed tomography scan (C) after improvement. Colonoscopy revealed mucosal healing in the sigmoid colon (A), and the blood vessels became visible. Although the descending colon was in the process of healing (B), we detected the improvement of the mucosal edema, discharge of pus, and the degree of stenosis. Although a computed tomography scan still showed a thickened wall with a narrowed lumen, the intramural air-filled abscess cavities within the wall of the descending colon had diminished.
1349-7235-56-1157-g003.jpg
PMC5491809_01_1349-7235-56-1157-g003.jpg
g003
Oral intake was restarted with an elemental diet, and she was later discharged home after confirmation of the improvement of her condition via colonoscopy (Fig. 3A and B) and computed tomography (Fig. 3C).