Seifert E
Radiologe. 1976 Nov;16(11):484-8.
Ulcerative colitis and regional colitis Crohn are the most frequent inflammatory diseases of the large bowel in Europe. Clinical differentiation of these disorders are difficult. Diarrhoe with bloody stools are predominant. In cases with Morbus Crohn anorectal fistulas and involvement of the terminal ileum are frequently found. In cases with ulcerative colitis anorectal fistulas are more rare but in this disease a carcinoma of the colon often develops, especially when the course is severe and the involvement of the colon is extended. Clinical symptoms, courses and complications of both diseases are described. In differential diagnoses endoscopic procedures especially coloscopy play an important role. In cases of ulcerative colitis about 90% the rectum is involved. Spontaneous haemorrhage of the colonic mucosa with edema and pseudopolyps are typical endoscopic findings. Most cases with Crohn's disease show flat and irregular ulcers within a normal mucosa. In later stage a "cobble stone" relief is demonstrable. Endoscopy and guided biopsy are not only important for differential diagnosis but also for treatment and prognosis.
溃疡性结肠炎和局限性肠炎（克罗恩病）是欧洲最常见的大肠炎症性疾病。这些疾病的临床鉴别诊断困难。以腹泻伴血便为主。在克罗恩病患者中，常发现肛门直肠瘘和回肠末端受累。在溃疡性结肠炎患者中，肛门直肠瘘较为少见，但在这种疾病中，结肠癌常易发生，尤其是在病情严重且结肠受累范围扩大时。本文描述了这两种疾病的临床症状、病程及并发症。在鉴别诊断中，内镜检查尤其是结肠镜检查起着重要作用。在溃疡性结肠炎患者中，约90%直肠受累。结肠黏膜自发性出血伴水肿和假性息肉是典型的内镜表现。大多数克罗恩病患者在正常黏膜内可见扁平且不规则的溃疡。在疾病后期可显示出“鹅卵石”样外观。内镜检查及引导下活检不仅对鉴别诊断很重要，对治疗及预后也很重要。
