Pathology Inflammatory Intestinal Disease Flashcards
Morphology of Sigmoid Diverticulitis
Flask like sacs along margins of taenia and penetrating blood vessels. Sacs show flat mucosa and thinnig muscle layer and entire wall.
Complications of Sigmoid Diverticulitis
Diverticuli may perforate, cause peridiverticulitis, pericolic abscesses and eventually peritonitis.
Symptoms of Sigmoid Diverticulitis
Intermittent Cramping, lower abdominal discomfort, constipation, bleeding
Differentiate Crohn’s from Ulcerative Colitis in terms of gross morphology
Crohn’s: Can effect BOTH Ileum and colon, skip lesions, strictures, Thick wall
Ulcerative Colitis: effects Colon ONLY, Diffuse distribution, No strictures, Thin wall
Differentiate Crohn’s from UC in terms of microscopic morphology
Crohn’s: Transmural inflammation, Deep knife like ulcers, lymphoid rxn, fibrosis, fistulas
UC: Inflammation limited to mucosa, pseudopolyps, superficial ulcers, Toxic megacolon
More gross morphology of Crohn’s
Mesenteric fat extending over serosal surface ‘creeping fat’. Strictures of colon show as ‘string sign’ on X-ray.
Complications of Crohns and extraintestinal manifestions
Pericholangitis, Primary Sclerosing Cholangitis and carcinoma.
Extraintestinal manifestions: Migratory polyarthritis, ankylosing spondylitis, erythema nodosum
Discuss Indeterminate Colitis
Overlap between Crohns and UC. Small bowel is not involved.
Discuss Colitis-Associated Neoplasia
Complication of UC and CD. The risk of dysplasia increases 8 to 10 years after onset. Pancolitis patients at greater risk than those with only left-sided disease.
Discuss surveillance of Colitis Associated Neoplasia
Patients put in surveillance program 8 yrs after diagnosis. Regular and extensive endoscopies and biopsies.
High Grade: invasive carcinoma; Colectomy
Low Grade: Monitored closely or colectomy
