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Ulcerative Colitis — RACP Paediatrics MCQ

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ModerateGastroenterologyUlcerative ColitisRACP Paediatrics

A 14-year-old girl presents with a 3-month history of bloody diarrhoea, abdominal pain, and 4 kg weight loss. Colonoscopy shows continuous mucosal inflammation extending from the rectum to the splenic flexure with loss of vascular pattern and contact bleeding. Histology shows crypt architectural distortion and crypt abscesses. What is the most likely diagnosis?

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Correct answer: C — Ulcerative colitis

Continuous mucosal inflammation starting from the rectum and extending proximally, with histological features of crypt abscesses and architectural distortion, is characteristic of ulcerative colitis. Crohn's disease typically shows skip lesions, transmural inflammation, and may affect any part of the GI tract. The Paris classification is used for paediatric IBD classification.

Reference: AUSPGHAN – 2024 – Position Statement on Management of Paediatric Inflammatory Bowel Disease