Inflammatory Bowel Disease-Pathology

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Slide 61.   Mucosal Erosion in Infectious Colitis

In some examples of acute self-limited colitis, mucosal erosions may be prominent.  The presence and distribution of these erosions may in themselves be a marker of specific etiologies.  In particular, erosions overlying lymphoid aggregates in colon (as illustrated in this image), or Peyer’s patches in terminal ileum, have been associated with both Salmonella ssp and Yersinia enterocolitica infections.  These erosions, because of their punched-out appearance and erythematous margins (when viewed endoscopically), have been likened to the superficial aphthous ulcers of Behçet’s disease, hence the term ‘aphthoid’ as previously discussed with slide 18.  Crohn’s disease may also exhibit this pattern of injury.  Infectious disorders are usually separable from Behçet’s by the presence of ischemia-induced changes in the latter.  Although Crohn’s disease can usually be excluded in this setting because it typically exhibits features of chronic mucosal injury, the best means of diagnosing infectious enterocolitis is careful examination and culture of stool.

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Islam MM, Azad AK, Bardhan PK, et al.: Pathology of shigellosis and its complications.  Histopathol 1994; 24:65-71.

Lee RG: The colitis of Behçet’ s syndrome.  Am J Surg Pathol 1986; 10:888-893.