Congenital ulcerative colitis

Neonatal ulcerative colitis is an extremely rare condition. Only six cases appeared in the literature. Its occurrence at birth has not been reported previously. We present the case report of such a patient. The propositus is a full-term newborn female, who was delivered vaginally after an uneventful pregnancy. Polyhydramnios with brown-green amniotic fluid was noticed. The baby developed transient aspiration syndrome. Marked abdominal distention and profuse prolonged mucoid diarrhea containing occult blood was present since birth. No oral feeding was attempted and she was fed parenterally. At the age of 7 days a barium enema revealed a spastic colon with irregular contour and nodular mucosal pattern. The rectal biopsy confirmed the diagnosis of ulcerative colitis and showed presence of ganglion cells. Steroid therapy did not alter the patient's condition and a subtotal colectomy and ileostomy were then performed, with no clinical improvement. The patient expired on the 37th day from sepsis and electrolyte imbalance.