GI Pathology II - Lower Flashcards
What can bowel inflam be divided into?
Chronic idiopahtic inflam bowel disease = crohn’s disease and ulcerative collitis
Other inflam conditions = diverticulitis, ischaemic colitis, infective colitis
What occurs in crohn’s disease?
Inflam from mouth to anus but not continuous. Inflam can spread from bowel wall to fat.
Granulomas present = inflam response
Complications of Crohn’s?
Bowel: Neoplasia Anal Fistula formation Perforation Obstruction Malabsorption
Where does ulcerative colitis start?
Starts in rectum and spreads distally
Only effects mucosa
Complications of ulcerative collitis?
Liver = fatty change Colon = blood loss Joints = arthritis Eyes Skin
Diverticular disease cause?
In the sigmoid colon
Holes in bowel wall = entry/exit for BVs
Low fibre diet = colon has to clamp to push food = pressure causes mucosa to be pushed through holes = can perforate once inflamed = faeces through it = causing peritonitis
Colorectal cancer is most common in which country?
New Zealand
Who gets colorectal cancer?
People with adenomas = are dysplastic
How does colorectal carcinoma develop?
Normal epi = adenoma = colorectal adenocarcinoma
What is hereditary nonpolyposis colorectal cancer? HNPCC
Lots of genes that code for DNA repair ….
How is resection coded?
R0 - tumour completely excised locally
R1 - microscopic involvement of margin by tumour
R2 - macroscopic involvement of margin by tumour
Prognosis and circumferential resection margin (CRM)?
CRM +ve 20% 5yr survival with 85% risk of local recurrence
CRM -ve 75% 5yr survival with 10% risk of local recurrence
How does Duke’s stage and prognosis work?
A - 95% 5yr survival
B - 75% 5yr survival
C - 35% 5yr survival
D - 25% 5yr survival
