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Pathology - Crohn's disease
Definition: An idiopathic inflammatory bowel illness distinguished by multifocal regions of inflammation that can affect any segment of the gastrointestinal system.
Epidemiology • Rare. • Significant occurrence between the ages of 20 and 30 years.
Aetiology and Pathogenesis • Believed to result from an aberrant mucosal immune response to luminal bacteria in genetically predisposed individuals. Mutations in the CARD15 gene, which encodes an intracellular receptor for bacterial peptidoglycan components, have been linked to small intestinal Crohn's disease in Caucasian populations. • Smoking elevates the risk. A definitive infectious etiology remains unsubstantiated.
Presentation: • Crampy pain in the right iliac fossa accompanied by diarrhea, typically non-bloody. Fever, malaise, and weight reduction are prevalent symptoms.
Macroscopy • The disease typically affects the terminal ileum and colon. • The involved intestine exhibits thickening with infiltration of mesenteric fat surrounding the anti-mesenteric barrier, referred to as 'fat wrapping.' • Adhesions and fistulas may be observed between contiguous loops of bowel. • The mucosal surface exhibits linear ulcers and cobblestoning.
Histopathology- Mucosal biopsies exhibit diversity in inflammation both within a single biopsy and among many biopsies, which is a critical characteristic. This is usually exhibited by distinct regions of inflammation near histologically normal crypts. Surface erosions and ulcerations may be evident. Poorly formed granulomas may occur, but they are often rare. • Resection specimens: deep fissuring ulcers delineated by reasonably normal mucosa. Lymphoid aggregates are located in the submucosa and muscle layers. Granulomas of suboptimal formation may be observed.
Prognosis: • Characterized by a relapsing and remitting trajectory. • The majority of patients necessitate surgical intervention at some stage to alleviate symptoms resulting from obstruction or fistula formation. • Elevated risk of small and large bowel adenocarcinoma. Extragastrointestinal signs encompass enteropathic arthropathy,anterior uveitis, gallstones, erythema nodosum and pyoderma gangrenosum.
Definition: An idiopathic inflammatory bowel illness distinguished by multifocal regions of inflammation that can affect any segment of the gastrointestinal system.
Epidemiology • Rare. • Significant occurrence between the ages of 20 and 30 years.
Aetiology and Pathogenesis • Believed to result from an aberrant mucosal immune response to luminal bacteria in genetically predisposed individuals. Mutations in the CARD15 gene, which encodes an intracellular receptor for bacterial peptidoglycan components, have been linked to small intestinal Crohn's disease in Caucasian populations. • Smoking elevates the risk. A definitive infectious etiology remains unsubstantiated.
Presentation: • Crampy pain in the right iliac fossa accompanied by diarrhea, typically non-bloody. Fever, malaise, and weight reduction are prevalent symptoms.
Macroscopy • The disease typically affects the terminal ileum and colon. • The involved intestine exhibits thickening with infiltration of mesenteric fat surrounding the anti-mesenteric barrier, referred to as 'fat wrapping.' • Adhesions and fistulas may be observed between contiguous loops of bowel. • The mucosal surface exhibits linear ulcers and cobblestoning.
Histopathology- Mucosal biopsies exhibit diversity in inflammation both within a single biopsy and among many biopsies, which is a critical characteristic. This is usually exhibited by distinct regions of inflammation near histologically normal crypts. Surface erosions and ulcerations may be evident. Poorly formed granulomas may occur, but they are often rare. • Resection specimens: deep fissuring ulcers delineated by reasonably normal mucosa. Lymphoid aggregates are located in the submucosa and muscle layers. Granulomas of suboptimal formation may be observed.
Prognosis: • Characterized by a relapsing and remitting trajectory. • The majority of patients necessitate surgical intervention at some stage to alleviate symptoms resulting from obstruction or fistula formation. • Elevated risk of small and large bowel adenocarcinoma. Extragastrointestinal signs encompass enteropathic arthropathy,anterior uveitis, gallstones, erythema nodosum and pyoderma gangrenosum.
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