Pathology of the Large Intestine

Question 1

What are some common diseases of the large bowl;?

Answer 1

Diverticular disease 
Ischaemia
Antibiotic induced colitis
Microscopic colitis
Radiation colitis

Question 2

What is diverticular diseases often related to?

Answer 2

Low fibre diet and increased intraluminal pressure

Question 3

When do you commonly only get symptoms of diverticular disease?

Answer 3

Only when it is complicated

Question 4

What are some complications of diverticular disease?

Answer 4

Inflammation

Rupture
Abscess
Fistula
Massive bleeding

Question 5

Describe who is most likely to get ischaemia of the large bowel?

Answer 5

The elderly

usually left sided diseases

Question 6

What is the aetiology of ischamia of the large bowel?

Answer 6

CVS disease 
A.F
Embolus 
Atherosclerosis of mesenteric vessels 
Shock
Vasculitis

Question 7

What are some histopathological clues to ischaemic colitis?

Answer 7

‘withering of crypts’
‘pink smudgy lamina propria’
‘fewer chronic inflammatory cells’

Question 8

What are some complications of ischaemic colitis?

Answer 8

Massive bleeding
Rupture
Stricture

Question 9

Describe antibiotic induced “Pseudomembranous” colitis?

Answer 9

Patents who are usually on broad spec antibiotics - C.Diff

Massive diarrhoea and bleeding

Patchy yellow membranous exudate on mucosal surface

Treat with Flagyl/Vancomycin

Question 10

What is collagenous colitis?

Answer 10

Increase in thickness of sub-epitheialial collagen

Thickened basement membrane

Associated with intraepiteial inflammatory cells

Check clinical history for watery diarrhoea, normal endoscopy, drug history etc

Question 11

Describe lymphocytic colitis?

Answer 11

No chronic architectural chances in crypts
Intraepithelial lymphocytes are raised
No thinking of BM