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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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History of ulcerative colitis. On surveillance colonoscopy. Biopsy shows low grade multifocal dysplasia and high grade foci. Colectomy needed?

Pathologist report says 3 sets of biopsies to satisfy ulcerative pancolitis. diagnosis. In 2003 I was diagnosed with UC. Have been on surveillance colonoscopy. There are low grade multifocal dysplasia and there are two high grade foci, one in a very tiny biopsy from somewhere on the left side and the second focus somewhere on the right side. Is it time for a colectomy?
Wed, 13 Nov 2013
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General & Family Physician 's  Response
HI, thanks for using healthcare magic

Colectomy in ulcerative colitis can be done as an emergency or elective procedure.

Elective colectomy is one with is scheduled for non emergency circumstances (like perforation, toxic megacolon).
Elective surgery is indicated for 3 main reasons- failed medical treatment, retarded growth in a child and cancerous transformation.

In terms of the cancerous transformation, the development of dysplasia or cancer is an absolute indication for surgery.With your recent results of dysplastic changes, it would be best to consider having the colectomy done.

I hope this helps
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