Clinical manifestations: chronic diarrhea, frequently bloody; anemia, rarely pain
x High colonoscopy with ileoscopy and tissue sampling from all bowel segments,
also to exclude carcinoma in long-standing cases; rectal biopsy is particularly
advised (for positive differentiation from Crohn disease)
x Gastroduodenoscopy may also be done if necessary.
x Radiography: double-contrast enema is necessary only if endoscopy cannot be
x Continuous pattern of intestinal involvement, usually confined to the rectum,
sigmoid colon, and descending colon
x Less commonly, there may be detectable wall thickening to a maximum of
8mm (not as pronounced as in Crohn disease); wall thickness apparently
correlates with the activity of the disease.
x Irregular hypoechoic or echogenic intraluminal wall indicating pseudopolyp
x Scans in long-standing cases show a rigid tube devoid of haustrations.
x Complication: toxic megacolon.
Accuracy of sonographic diagnosis: The sonographic signs may also appear in infectious bowel diseases, so it is important to proceed with endoscopic examination and biopsy.