inflammatory bowel disease Flashcards
where does churns disease usually affect ?
terminal ileum and colon but may be seen anywhere from the mouth to anus.
Etiology of chrons disease ?
Smoking
TURNER SYNDROME
x
x
Clinical features about chron’s dissase
Diarrhoea usually non-bloody
Weight loss
mouth ulcers,
perianal disease
Abdominal mass palpable in the right iliac fossa
Clinical features of UC?
Bloody diarrhoea !
Abdominal pain in the left lower quadrant
Tenesmus
Extra intestinal specific to chrons diseas
Gallstones are more common secondary to reduced bile acid reabsorption
Oxalate renal stones - impaired bile acid rebsorption increases the loss calcium in the bile. Calcium normally binds oxalate.
Extraintestinal specific to UC
Primary sclerosing cholangitis more common
Complications of Chrons
Obstruction,
fistula,
perianal abscess
colorectal cancer
small bowel cancer
osteoporosis
Complication of UC?
colorectal cancer high in UC than CD
Pathology of Chrons ?
Lesions may be seen anywhere from the mouth to anus
Skip lesions may be present
Pathology of UC
Inflammation always starts at rectum and never spreads beyond ileocaecal valve
Histopathology of UC
No inflammation beyond submucosa
(unless fulminant disease) - inflammatory cell infiltrate in lamina propria)
form crypt abscesses
depletion of goblet cells and mucin
Histopathology of Chrons
Inflammation in all layers from mucosa to serosa
increased goblet cells
granulomas
Endoscopy appearance of Chrons ?
Deep ulcers, skip lesions - ‘cobble-stone’ appearance
Endoscopy of UC
Widespread ulceration with preservation of adjacent mucosa which has the appearance of polyps (‘pseudopolyps’)
