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Dolichocolon as a Potential Modifier of Pediatric Ulcerative Colitis Phenotype

Kellermayer, R.; Berens, D. P.; Szigeti, R. G.

2025-08-21 gastroenterology
10.1101/2025.08.20.25333704 medRxiv
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BackgroundDolichocolon (DC) is an underrecognized anatomic variant associated with constipation; its association with pediatric ulcerative colitis (UC) is unknown. MethodsWe retrospectively reviewed abdominal MRI and CT scans in pediatric UC, Crohns disease (CD), and non-IBD controls, classifying DC subtypes in 111 cases. ResultsDC prevalence was higher in UC than CD or controls. Type 1 DC predominated in proctitis/left-sided UC (E1/E2), while Type 2 DC was enriched in extensive/pancolitis (E3/E4). Complex DC (Types 1+2) was observed only in UC. DiscussionDC may modify UC distribution independent of constipation, representing a potential developmental modifier of pediatric UC phenotype and a nidus for prevention. Graphic abstractCreated with BioRender by D. Berens

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