ECCO Topical Review on Clinicopathological Spectrum and Differential Diagnosis of Inflammatory Bowel Disease

Roger Feakins*, Joana Torres, Paula Borralho-Nunes, Johan Burisch, Tiago Cúrdia Gonçalves, Lissy De Ridder, Ann Driessen, Triana Lobatón, Luis Menchén, Aart Mookhoek, Nurulamin Noor, Magali Svrcek, Vincenzo Villanacci, Nina Zidar, Monika Tripathi

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

18 Citations (Scopus)


Introduction: Many diseases can imitate inflammatory bowel disease [IBD] clinically and pathologically. This review outlines the differential diagnosis of IBD and discusses morphological pointers and ancillary techniques that assist with the distinction between IBD and its mimics. Methods: European Crohn's and Colitis Organisation [ECCO] Topical Reviews are the result of an expert consensus. For this review, ECCO announced an open call to its members and formed three working groups [WGs] to study clinical aspects, pathological considerations, and the value of ancillary techniques. All WGs performed a systematic literature search. Results: Each WG produced a draft text and drew up provisional Current Practice Position [CPP] statements that highlighted the most important conclusions. Discussions and a preliminary voting round took place, with subsequent revision of CPP statements and text and a further meeting to agree on final statements. Conclusions: Clinicians and pathologists encounter a wide variety of mimics of IBD, including infection, drug-induced disease, vascular disorders, diverticular disease, diversion proctocolitis, radiation damage, and immune disorders. Reliable distinction requires a multidisciplinary approach.

Original languageEnglish
Pages (from-to)343-368
Number of pages26
JournalJournal of Crohn's and Colitis
Issue number3
Early online date4 Aug 2021
Publication statusPublished - Mar 2022

Bibliographical note

Funding Information:
There was no funding for this project. ECCO provided administrative support.

Publisher Copyright:
© 2021 The Author(s).


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