Patho 1st Lecture, 2nd Half

Gastric Adenocarcinoma and Iflammatory Bowel Syndrome

Crohn's Disease and Cholecystitis

Peptic Ulcer Disease and Crohn's Disease

Crohn's Disease and Chronic Ulcerative Colitis

Inflammatory Bowel Syndrom and Peptic Ulcer Disease

CUC has a prevalence of 20-40/100,000 while Crohn's has a prevalence of 70-150/100,000.

CUC is 2-3 times more prevalent than Crohn's Disease.

Crohn's disease is 2-4 times more prevalent than CUC.

CUC has a prevalence of 10/100,000 while Crohn's has a prevalence of 1/100,000.

Crohn's Disease

Inflammatory Bowel Syndrome

Inflammatory Bowel Disease

Chronic Ulcerative Colitis (CUC)

Diverticulosis

In 50% of cases, the disease affects both the terminal ileum and colon. In 30%, only the ileum, and in 20% of cases, limited to the colon.

In 50% of cases, the disease affects the colon only. In 30% of cases, both the colon and the terminal ileum, and in 20% of cases, limited to the terminal ileum.

In 75% of cases, the disease affects both the terminal ileum and the colon. In the remainding 25%, the disease afflicts only the colon.

In 95% of cases, the disease affects only the terminal ileum. The remainding 5% occurs in the Duodenum.

In 50% of cases, the disease affects both the duodenum and the terminal ileum. In 30%, it affects the colon and the rectum. And in 20% of cases, only the colon.

True

False

True

False

Inflammation extending through the entire wall of the intestine forming patch-like designs seen in Crohn's disease.

Non-caseating granulomas within the mucosa and submucosa associated with fibrosis of the muscularis and the serosa seen in Crohn's disease.

Creeping fat on the surface of the mucosa seen in CUC.

Creeping fat on the surface of the mucosa arranged in a patch-like formation seen in Crohn's disease.

Shallow mucosal defects overlying lymphoid aggregets which suggest immune cell involvement seen in Crohn's disease.

Peyer's Patches

Skip Lesions

Transmural inflammation

Rubber-hose fibrosis

Cobblestoning

The narrowing of the fibrotic intestines causing stricture.

Anal involvement.

Inflammation of the serosa leading to adhesions with adjacent intestinal loops.

Shallow mucosal defects overlying lymphoid aggregates.

Cobblestone appearance interspersed between more normal appearing mucosa.

True

False

Bleeding, rectal involvement, and fever.

Fever and constipation, associated with chronic exacerbations.

Nasea, heartburn, indigestion, upset stomach, diarrhea.

Diarrhea, abdominal pain, and weight loss characterized by exacerbations and remissions.

Nausea, vomitting, and fever.

Endoscopy and liver biopsy

Colonoscopy, X-ray, and mucosal biopsy

Ultra Sound, Colonoscopy, X-ray

CT scan, Endoscopy, biopsy

X-ray, mucosal biopsy, HIDA scan.

CUC with transmural inflammation

Crohn's disease-cobblestone mucosa and creeping fat

Crohn's disease with rubber hose fibrosis

CUC with raw, ulcerated hemorrhagic mucosa.

A diffuse disease that does not usually extend into the ileum aside from mild inflammation of the terminal ileum ("backwash ileitis")

Initially starts as rectal lesions and spreads proximally, eventually involving the entire colon.

A disease leading to the involvement of the colon which is typically segmental.

An Intestinal Inflammation of unknown etitology that most often involves the colon.

A disease typically limited to thecolonic mucosa and submucosa.

Thick, purulent, and prone to bleeding

Shows cobblestone pattern with creeping fat.

Prone to deep fissures penetrating into the muscle wall.

Sandpaper, friable, and prone to bleeding.

CUC

PUD

IBS

Crohn's disease

Barretts esophagus.

Rubber Hose Fibrosis

Ulcerating Hemorrhagic mucosa

Crypt Abscesses

Creeping Fat

They are due to neoplastic epithelium that show no evidence of normal differentiation.

Small remnants of inlfammed mucosa that appear to be elevated over the base of the surrounding ulcerations

Dilated glands due to the obstructed flow of mucus.

Invading aliens pushing through the lumen trying to make their way into the vasculature.

Small remnants of inflammed mucosa that appear to be elevated over the base of the surrounding ulcerations known as inflammatory pseudopolyps.

Atrophy of the crypts with aggregates of lymphocytes in the base of the crypts known as crypt abscesses.

Mild inflammation of the terminal ileum that can occur in CUC known as backwash ileitis.

Colonic ulcerations that spread through the entire colon and become confluent during ulcerative colitis known as serpiginous ulcerations.

True

False

7%

25%

55%

95%

70%

True

False

IBS

CUC

GERD

Crohn's Disease

Apendicitis

CUC

Gastric Adenocarcinoma

PUD

Crohn's Disease

Colonoscopy and biopsy

Clinical, radiographic, and pathologic evaluation.

Endoscopy and HIDA scan

Biopsy only