Pathological versus clinical differential diagnosis in inflammatory bowel disease

摘要

For decades the differential diagnosis of inflammatory bowel diseases (IBD) was restricted to the distinction of idiopathic ulcerative colitis (UC) from Crohn's disease (CD). With the advent of modern therapies, including new concepts of surgical treatment, the importance of this distinction has increased. In parallel, a growing number of causes and forms of non-idiopathic IBD was recognized (see Table 1), As a consequence the previous criteria for the diagnosis of UC and CD have lost their significance.In theory, a diagnosis of either idiopathic UC or CD is a matter of exclusion; it requires careful distinction from other forms of IBD, In practice UC and CD are more liberally used clinical diagnoses, while many of the non-idiopathic forms of IBD are rarely considered. Probably as a result, the clinical diagnosis of idiopathic IBD (CD or UC) is frequently not confirmed by the histopathological findings in the surgical specimen (25% in our series of 1200 IBD patients operated),