Practical points in the pathology and surgical treatment of ulcerative colitis. A critical review

Primary Crohn's disease of the colon and rectum

“…Only those patients with the characteristic pathological features of ulcerative colitis described by Dukes (1954) and by Warren and Sommers (1954) were included in this group.…”

“…Although 'cicatrizing enteritis' and 'granulomatous colitis' are useful terms they do not adequately describe the important and characteristic features of this disease. Cicatrizing enteritis can be found in a number of chronic inflammatory disorders (Lumb, 1951), and granulation tissue may be found in the superficial submucosa in the healing phase of ulcerative colitis (Dukes, 1954). Wells (1952), describing cases of regional colitis characterized by fibrosis, non-caseating tubercles, and multinucleated giant cells, called the condition 'Crohn's disease of the colon'.…”

“…Wells (1952), describing cases of regional colitis characterized by fibrosis, non-caseating tubercles, and multinucleated giant cells, called the condition 'Crohn's disease of the colon'. Because this eponymous title conveys a much fuller meaning than any other term previously employed it has become justly popular with British surgeons and pathologists, and is now an accepted part of our terminology (Dukes and Lockhart-Mummery, 1957;Brooke, 1959;Watkinson, Thompson, and Goligher, 1960;Lockhart-Mummery and Morson, 1960;Nevin, 1961).…”

“…Goligher (1961) states that there is no reason to suppose Crohn's disease loses its notorious predilection to recurrence because it happens to have transferred its habitat from the small intestine to the large. Dukes (1959), however, believes that a careful distinction should be made between cases of primary Crohn's disease of the large intestine and cases of regional ileitis with or without colonic involvement. This study was under-taken to see if this distinction was worth making, to assess the incidence of primary Crohn's disease of the large intestine relative to ulcerative colitis, and to compare the clinical and pathological features of these cases with cases of regional ileitis and ulcerative colitis.…”

Irreversible Changes of Ulcerative Colitis

“…Closer investigation, however, reveals that the duration of the disease is related to the development of carcinoma. Figures as high as 50% (Dukes and Lockhart-Mummery, 1957), 36% (Lyons and Garlock, 1951), and 30% (Cattell and Boehme, 1947) have been recorded when the disease has been present for ten years or more. Our own experiences have been similar.…”