Session 8 - Large Intestine + IBD Flashcards
How does the large intestine differ from the small intestine macroscopiclly?
Large intestine is much shorter
Large intestine is much wider
Large intestine has no plicae circulares
Large intestine has no villi.
Large intestine has epiploic appendages (fatty tags)
How is the muscle arranged in the large intestine?
The circular muscle is complete
The out longitudinal muscle is in 3 bands = called the tines coli
What happens when the tinea coli contract?
Forms sacculations called haustra
What channels in the colon are responsible for water absorption ?
ENaC.
What is a mass movement?
All the poo moved into the rectum.
What age of patient are affected by chron’s disease ?
Bimodal age pattern
15-30 & 60 years olds
What age are people usually affected by UC?
Young adults
Compare chron’s disease and UC.
Chrons disease: Anywhere in GI tract Transmural Skip lesions Bleeding unlikely Perianal disease Fistulae UC: Begins in rectum - can involve whole colon Continuous Mucosal inflammation Bleeding likely No perianal disease No fistulae
Extra-intestinal manifestations of inflammatory bowel disease.
MSK pain - arthritis
Skin - erythema nodosum (bruise nodules on knee)
Liver
Eye
Gross pathological changes in chrons disease?
Red, inflamed gut wall (hyperaemia) Discrete superficial ulcers Transmural inflammation - narrowing of lumen, thickening of bowel wall Fistula COBBLESTONE APPEARANCE
What microscopic appearance is pathopneumonic of Chron’s disease
Granuloma
What gross macroscopic changes can you see in UC?
Loss of haustra
Pseudopolyps
What microscopic change can be seen more commonly in UC?
Crypt abscess
What features can be seen radiologically with Chrons?
Narrowing - string of beads appearance
What features can be seen radiologically with UC?
Lead pipe colon - no haustra
Continuous ulceration
