Segmental (Ulcerative) Colitis

Abstract

Twelve years ago the authors, in conjunction with Dr. John H. Garlock,1 presented a series of 77 cases of with an attempt to describe the life-cycle of this disease as based upon a follow-up study covering 17 years. We were subsequently dissatisfied with this title for two reasons: first, this localized form of colitis is not always right-sided; second, it is not always regional, nor does it always remain regional. We wish now to report a series of 140 cases of colitis, that is, the type of nonspecific ulcerative colitis in which the more distal segments of the colon and also the rectum are free ofthe disease. We are not entirely discarding the term regional because we now recognize that some of the right-sided forms are granulomatous in nature and simulate enteritis or ileitis in their chronic granulomatous nature. On the other hand, we adopt the title segmental for those other types which, although free of rectal involvement, are ulcerative in the same sense which we apply to the more familiar type of universal ulcerative colitis with predominantly rectal involvement. The 140 cases we are reporting are all private patients seen in the office and the hospital, and have been observed for up to 30 years. During this period our office records include 1415 cases of universal ulcerative colitis, so that the group constitutes approximately 10 per cent of the total. This is a slight increase over the 8 per cent we reported in 1947, and in recent years it appears that the incidence of colitis is increasing, or at least is being recognized more frequently. In 1930 Bargen and Weber2 reported 23 cases of migratory chronic ulcerative colitis; in 1938 Crohn and Berg3 re* Read at the 60th Annual Meeting of the American Gastroenterological Association, Atlantic City, N .. J., June 5 and G, 1959.