Colitis in Infancy and Childhood

The differential diagnosis of colitis in pediatrics encompasses numerous entities. Many are infectious, of acute onset, follow a self-limited course, and are diagnosed by a combination of clinical features and microbiologic cultures. These rarely come to the pathologist’s attention unless complications develop or in the setting of immunodeficiency. Endoscopic biopsies and surgical specimens are obtained most frequently in entities without an identifiable pathogen or which follow a prolonged clinical course, when the possibility of chronic inflammatory bowel disease is raised, or in the course of therapy and management of complications. The evaluation of specimens in these settings is essential to confirm the presence of an inflammatory disorder, to establish a diagnosis, to distinguish acute, self-limited disease from chronic processes, to determine the extent of disease, and to assess the efficacy of therapy.