Lec 29 Flashcards
What happens to crypts in IBD?
have distortion of crypts; neutrophils within crypt epithelium
can form crypt abscess
Which IBD disease associated with creeping fat?
crohns
Which IBD disease associated with penetrating fissures and peritonitis?
crohns
What is major complication of toxic megacolon?
perforation
Is patient with crohns colitis or ulcerative colitis at more risk for colon cancer?
same risk
What do you see histologically in pseudomembranous colitis?
surface necrosis with dilated crypts; volcano-like acute inflammatory exudate
dilated glands filled with mucous
What is morphology of clostridium difficile?
gram positive spore forming rod
endemic in health care settings
toxins A and B –> necrosis of colonic epithelial cells
What are 3 treatments for CDiff colitis?
metronidazole
vancomycin
fecal transplant
What is string sign in barium xray?
sign of stenosis in crohns
What do you see on endoscopy with colonic ischemia?
- dusky red discoloration with ulceration
What are features of colon that make it at risk for ischemia?
- low blood flow relative to tissue mass
- poor collateral flow
- sensitivity to vasoconstrictors
- watershed regions
What are the two watershed areas of colon?
splenic flexure = SMA + IMA
sigmoid colon = IMA + hypogastric artery
Can superficial ischemia of colon heal completely? What about injury deep to mucosa?
superficial can heal; deep may cause stricture when it heals
Who is at risk for colonic ischemia?
elderly
pts in shock
oral contraceptives; vasoconstrictive drugs
What are complications of diverticular disease?
painless bleeding from small artery at base of diverticulum
inflammation –> diverticulitis