colorectal pathology 2 Flashcards
can antibiotics cause colitis?
yes
what does a diverticulum look like?
extra openings in the mucosa of the large bowel
outpouchings on outside of large bowel
very nobbly
when are diverticuli dangerous?
can become blocked and inflamed
causing abscesses, adherence and stricture
what does diverticuli look like histologically?
not neoplastic
looks fairly normal if not inflamed
what are the symptoms of diverticular disease?
can be asymptomatic
only get symptoms if complicated
what is diverticular disease associated with
western diet
reduced fibre
increased intraluminal pressure
how does a diverticulum appear?
mucosa herniated through its own muscle wall due to increased pressure
true diverticulae = all layers involved (appendix)
what are the complications of diverticular disease?
inflammation rupture abscess fistula haemorrhage
what does colitis look like?
very red lumen walls histologically: - withering of crypts and - smudging of lamina propria - few chronic inflammatory cells
what can cause ischaemic colitis?
CVD atherosclerosis of mesenteric vessels A. fibrillation shock embolus vasculitis elderly
is ischaemic colitis right or left sided?
usually left sided
what are the possible complications of ischaemic colitis?
haemorrhage
rupture
stricture
what does antibiotic induced (pseudomembranous) colitis look like?
speckled yellowish plaques of exudate on mucosa of large intestine
causes by spots of bacterially induced ischamia
what might antibiotic induced (pseudomembranous) colitis look like histologically?
volcano explosion
who gets antibiotic induced (pseudomembranous) colitis
patients on broad spectrum antibiotics
C. Diff selected out
what might watery diarrhoea in 5060 yr old female indicate?
collagenous colitis (AKA microscopic colitis) (autoimmune disease)
what does collagenous colitis look like histologically?
thick band of collagen under epithelium (causes diarrhoea)
how is collagenous colitis diagnosed?
biopsy
what might watery diarrhoea with no thickened collagen band indicate?
looks like coeliac disease
lymphocytic colitis
(type of microscopic colitis)
what disease is lymphocytic colitis associated with?
coeliac disease
red, focally congested colon on colonoscopy + branched crypts in random distribution but no inflammation + vascular spaces in lamina propria + previous radiotherapy treatment?
radiation colitis
what is radiation colitis?
iatrogenic
what causes acute infective colitis?
infection
rarely drugs
how is acute infective colitis diagnosed?
stool culture recognise symptoms (diarrhoea)
how is acute infective colitis treated?
usually self limiting?
