Crohn's disease without granuloma was regarded as colitis ulcerosa

The differential diagnosis of IBD has been the subject of research for decades. The diagnosis of Crohn disease (CD) is based on the loco-regional, transmural and granuloma forming features of inflammation. Recent studies indicate that the granuloma formation is not an absolute criterion of CD. 52 years old smoker patient with IBD was observed, who's illness was diagnosed as colitis ulcerosa (CU) twenty years ago. Frequent reactivation was detected in the first 13 years of his disease, which led to a subileus causing stenos of the sigmoid colon. The patient held totally aloof of the surgical intervention. The ini…