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December 21, 1957


JAMA. 1957;165(16):2052-2054. doi:10.1001/jama.1957.02980340018005

Regional enteritis differs from ulcerative colitis in the sequence of events and in the resultant gross changes. Ulcerative colitis is distinguished primarily by shallow, extensive ulcers in the mucosa and submucosa, with lymphangitis following later and no shortening or induration of the mesentery, while regional enteritis is distinguished by small, deep lesions involving all coats, with early, obliterative lymphangitis, marked changes in the mesentery, and the frequent production of granulomas, stenoses, and fistulas. The lesions of regional enteritis are commonly characterized by abrupt transitions from abnormal to normal tissue. Thirty-one lesions observed in 28 patients were studied as to their distribution. Twenty-six were confined to the ileum, one was confined to the jejunum, and the rest were in two different segments of the intestine. All were marked by mucosal ulceration and lymphoid hyperplasia, and in most there was stenosis, lymphatic dilation, submucosal edema, and formation of granulomas; accompanying fistulas and intramural abcesses were found with less than one-fifth of the lesions.