A 22 year-old woman comes to the emergency by Dr. Laurence Bailen

Question 15 / 32: A 22 year-old woman comes to the emergency room with crampy left lower quadrant abdominal pain, 10-12 small volume bloody bowel movements daily with urgency to move her bowels, and a 5 lb weight loss in the past 2 weeks. She has a low grade temperature and a mildly tender abdomen on physical exam. She has a colonoscopy which shows pinpoint ulcerations and friable mucosa throughout the entire colon in a continuous distribution. Biopsies are taken from the colon. Multiple stool cultures are all negative.

Which of the following would you most likely find in this patient?

Anti-saccharomyces cerevisiae antibodies (ASCA)

Granulomas on histologic analysis

Fstulae seen on a barium enema

Peri-nuclear anti-neutrophil cytoplasmic antibodies (P-ANCA)

Strictures seen on a barium small bowel x-ray

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Explanation:

Clinical description of case of ulcerative colitis (UC). P-ANCA is more commonly found in UC. The other answers are findings seen in Crohn’s disease.

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Gastrointestinal Pathophysiology Self-Assessment

Author:

Dr.Laurence BailenProfessor

Tufts University School of Medicine

USA

Access: Public

Attribution: Laurence Scott Bailen, Tamsin Knox, Paul Abourjaily, Fredric D. Gordon,Marshall Kaplan,Andrew G. Plaut. PPY 222 Gastrointestinal Pathophysiology, Spring 2007. (Tufts University OpenCourseWare), http://ocw.tufts.edu/Course/47 (Accessed 3 May, 2014). License: Creative Commons BY-NC-SA

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