FULMINANT PRIMARY MANIFESTATION OF CROHNS-COLITIS - HOT CROHNS-DISEASE

Following the very short course of a disease with watery diarrhea, fev er, nausea, meteorism and a severe feeling of general illness, a 22-ye ar-old patient was diagnosed as having a toxic megacolon, and a subtot al colectomy was carried out. The postoperative progression was uncomp licated and the patient recovered quickly. The examination of the oper ation specimen revealed a serious ulcerous colitis with relative omiss ion of the rectum and the distal sigmoid colon. After critical evaluat ion of the histological findings, it was judged to be a fulminant Croh n's colitis and: for the purposes of differential diagnosis, different iated from ulcerative colitis and colitis indeterminate. The formal pa thogenesis of the inflammatory-ulcerous processes is discussed, in par ticular with regard to the activation of the macrophages and the very short anamnesis in a clinically established primary manifestation of t he disease.