A 30-year-old male presents with bloody diarrhea and tenesmus. Sigmoidoscopy reveals continuous circumferential mucosal inflammation extending proximally from the rectum. What is the diagnosis?
Answer and explanation
Correct answer: D. Ulcerative colitis
- Step 1: Ulcerative colitis is characterized by mucosal and submucosal inflammation restricted to the colon.
- Step 2: The endoscopic finding of diffuse, confluent mucosal erythema, friability, and ulceration extending continuously from the rectum without unaffected skip areas is diagnostic of ulcerative colitis.
Answer
Ulcerative colitis.
Why not the others: Crohn disease exhibits patchy transmural inflammation with endoscopic skip lesions and deep linear cobblestone ulcers. Ischemic colitis typically presents in older patients with vascular disease, affecting the watershed areas like the splenic flexure with rectal sparing. Celiac sprue involves the proximal small intestine rather than the colonic mucosa.
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