Flashcards in CH10 - Gastrointestinal Pathology Deck (345)
What is involved in inflammation with ulcerative colitis?
Crypt abscesses with neutrophils
What is the gross appearance of ulcerative colitis?
Pseudopolyps, loss of haustra ? lead pipe sign on imaging
What are the complications for ulcerative colitis?
Toxic megacolon and carcinoma
For ulcerative colitis what is the risk based on?
Its based on extent of colonic involvement and duration of disease (generally not a concern until >10 years of disease)
What are the associations for ulcerative colitis?
Primary sclerosing cholangitis and p-ANCA positivity
What is the effect of smoking on ulcerative colitis?
Smoking protects against it
What is the wall involvement for crohns disease?
Full thickness inflammation with knife like fissures
What is the location for Chrons disease?
Anywhere from mouth to anus with skip lesions
What is the most common and least common site for chrons disease?
Most common is the terminal ileum and the least common is the rectum
What are the symptoms for chron?s disease?
Right lower quadrant pain (ileum) with non bloody diarrhea
What is involved with the inflammation in Crohn?s disease?
Lymphoid aggregates with granulomas (40% of cases)
What is the gross appearance of Crohn Disease?
Cobblestone mucosa, creeping fat, and strictures (string sign on imaging)
What are the complications for Crohns Disease?
Malabsorption with nutritional deficiency, calcium oxalate nephrolithiasis, fistula formation, and carcinoma if colonic disease is present
What are the associations for Crohns disease?
Ankylosing spondylitis, sacroiliitis, migratory polyarthritis, erythema nodosum and uveitis
What effect does smoking have on Crohns disease?
It increases the risk for developing Crohns disease
What is hirschsprung disease?
Defective relaxation and peristalsis of rectum and distal sigmoid colon
What is hirschsprung disease associated with?
What is hirschsprung disease due to?
congenital failure of ganglion cells which are neural crest-derived, to descend into myenteric and submucosal plexus
Where is the myenteric (Auerbach) plexus located?
between the inner circular and outer longitudinal muscle layers of the muscularis propria and regulates motility
Where is the submucosal (Meissner) plexus located?
in the submucosa and regulates blood flow, secretions, and absorption.
What are the clinical features for hirschsprung disease based on?
What are the clinical features for hirschsprung disease?
1. Failure to pass meconium 2. Empty rectal vault on digital rectal exam 3. Massive dilatation (megacolon) of bowel proximal to obstruction with risk for rupture
In hirschsprung disease what does rectal suction biopsy reveal?
lack of ganglion cells.
What is the treatment for hirschsprung disease?
involves resection of the involved bowel; ganglion cells are present in the bowel proximal to the diseased segment.
What is colonic diverticula?
Outpouchings of mucosa and submucosa through the muscularis propria (false diverticulum)
What is colonic diverticula related to?
What is colonic diverticula associated with?
constipation, straining, and low-fiber diet; commonly seen in older adults (risk increases with age)
From where does the colonic diverticula arise?
where the vasa recta traverse the muscularis propria (weak point in colonic wall)
What is the most common location for colonic diverticula?