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May 24, 1947


JAMA. 1947;134(4):334-338. doi:10.1001/jama.1947.02880210012003

Eight per cent of all cases of ulcerative colitis of the nonspecific type are regional or right sided in anatomic distribution. They represent a distinctive subgroup, inasmuch as by sigmoidoscopic examination the rectum is free of disease. In this subgroup the pathologic process begins and is commonly limited to a segment or segments of the proximal colon; its life history is characterized by a progressive march to the left, until by skip lesion or by continuity the whole colon from cecum to sigmoid may become interruptedly or continuously involved.

Clinically right-sided or regional or segmental colitis is less severe in its local signs and symptoms than is universal or left-sided colitis with its predominantly rectal involvement; that is the diarrhea, the urgency, the straining and the bloody stools are less pronounced. On the other hand, the constitutional manifestations are more apparent and are characterized by fever, often continuous, by manifestations

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