tutorial 14 - inflammatory bowel disease Flashcards
What are the 2 types of inflammatory bowel disease?
Crohn Disease, Ulcerative colitis
Which part of the GI tract is affected by Crohn disease?
Any part from mouth to anus may be affected, but most commonly it is the terminal ileum or cecum that are involved.
What layers of the gut tube are affected in Crohn disease?
All layers of the affected segment (transmural inflammation), resulting in thickened, swollen gut wall
What is the gross morphology of the gut wall in Crohn disease?
Deep linear fissures with bulging inflamed mucosa between - cobblestone appearance.
Wall is also thickened and lumen narrowed.
Which type of IBD has skip lesions?
Crohn disease
What type of IBD has continuous colonic involvement, beginning at the rectum?
Ulcerative colitis
What are the histological features on the bowel wall in Crohn disease?
- inflammatory infiltrate in all layers of wall.
- mucosal crypts filled with neutrophils forming crypt abscesses.
- Non-caseating granulomas in the muscle layers and submucosa
What type of IBD has non-caseating granulomas?
Crohn disease
What are the complications of Crohn’s disease?
malabsorption in SI, bowel perforation or abscess, fistula, sinus to skin
What part of the GI tract is affected in Ulcerative colitis?
The colon only
What layers of the gut tube are affected in ulcerative colitis?
Mucosa and superficial submucosa - ulcers are shallow and broad-based
What is the gross morphology of the affected colon in ulcerative colitis?
Broad based ulcers with pseuodopolyps
What are pseudopolyps in ulcerative colitis?
Areas of regenerating mucosa between shallow ulcers
What is the most serious complication of ulcerative colitis?
Toxic megacolon
What is the pathogenesis of toxic megacolon secondary to ulcerative colitis?
Inflammation in the gut wall leads to release of inflammatory mediators that inhibit neuromuscular function in the colon leading to distention - megacolon
