Sm Intestine and Colon Path Pt 2 Flashcards
Most common cause of acute diarrhea
infectious diarrhea
Dx of C diff colitis
PCR of stoool
for toxin-producing strains
Ulcerative colitis vs Crohn’s disease
UC: continuous, confluent inflammatory changes of mucosa (not transmural) that begins in rectum
Crohn’s: transmural skip lesions
Which may involve small bowel? UC or Crohn’s
Crohn’s
UC only affects colon
UC manifestations
blood diarrhea, proctitis
Crohn’s manifestations
variable, abdominal pain, mild diarrhea, fever
Indeterminant colitis
overlap of UC and Crohn’s
Serology
UC
Crohn’s
UC: pANCA +
CD: ASCA +
UC complications
megacolon
fistula formation
colitis-associated dysplasia –> adenocarcinoma
Crohn’s complications
fistula formation
colitis-associated dysplasia –> adenocarcinoma
Quiescent colitis
persistent crypt architectural distortion w/o active inflammation
Diversion colitis
colitis of blind distal segment that is excluded from fecal stream
following surgery to form ostomy
caused by short-chain FA deficiency
Neonatal necrotizing enterocolitis
transmural necrosis –> bacterial overgrowth –> gas formation (pneumocosas intestinalis)
Microscopic colitis
types
lymphocytic colitis
collagenous colitis
Lymphocytic colitis
disease category
findings
microscopic colitis
increased lamina propria chronic inflammation, plasma cells, increased intraepithelial lymphocytes and surface epithelial damage
Collagenous colitis
disease category
findings
microscopic colitis
band of subepithelial collagen + inflammatory changes
Presentation of microscopic colitis
watery diarrhea
gross colonoscopy benign
Drug induced enterocolitis
colonoscopy findings
drugs
patchy, superficial ulcers
NSAIDs, chemo, Abx –> C. diff, graft-v-host
IBS Dx
clinically
chronic relapsing syndrome, often either diarrhea- or constipation-predominant
Ischemic bowel disease
etiologies
arterial/venous obstruciton
hypoperfusion
Likely bowel segments affected by ischemic bowel disease
at water shed areas
ie splenic flexure, rectal area
Complications of ischemic bowel disease
transmural necrosis
Angiodysplasia
malformed submucosal and mucosal blood vessels
Dx: colonoscopy
Outpouchings of diverticuli are commonly seen in this area
where vessels or nerves penetrate mucosal layer
–> when they perf, they bleed
Tx of diveriticulitis
clear liquid diet (bowel rest)
Abx
high fiber
surgery
Solitary rectal ulcer syndrome
etiology
malfunction of puborectalis muscle –> excessive straining
rectal mucosal prolapse –> ulcers and polypoid lesions
Solitary rectal ulcer syndrome
manifestations
young
blood in stool, alternating diarrhea and constipation
