The Differential Diagnosis of Acute Colitis: Clues to a Specific Diagnosis

Surg Pathol Clin. 2017 Dec;10(4):863-885. doi: 10.1016/j.path.2017.07.008.


This review describes a systematic approach to the interpretation of colonic biopsy specimens of patients with acute colitis. Five main histologic patterns are discussed: acute colitis, focal active colitis, pseudomembranous colitis, hemorrhagic colitis, and ischemic colitis. For each pattern, the most common etiologic associations and their differential diagnoses are presented. Strategies based on histologic analysis and clinical considerations to differentiate acute from chronic colitides are discussed.

Keywords: Acute colitis; Drug-induced colitis; Hemorrhagic colitis; Infectious colitis; Ischemic colitis; Pseudomembranous colitis.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Biopsy
  • Colitis / diagnosis*
  • Colitis / pathology
  • Colon / pathology
  • Diagnosis, Differential
  • Humans