Liver & GIT
A 25 year old male presents with a history of chronic diarrhea. Pathological examination reveals cryptitis and crypt abscesses. The likely diagnosis is:(AI 2008)
|A||Crohn' s disease|
It includes ulcerative colitis and Crohn’s disease. It has two peaks-one between 15-30 years and second between 60-80 years. High prevalence in urban and high socioeconomic class.
Ulcerative Colitis (Ref. H-18thedi, Pg 2477)
Definition – It is a chronic, recurrent disease characterized by diffuse mucosal inflammation involving the rectum and large intestine .
Ulcerative Colitis ismore common in NON SMOKERS !!!.
a. 40-50% patients have disease limited to rectum and recto sigmoid.
b. 30-40% have disease involving part of colon along with rectum.
c. 20% have total colitis.
d. Proximal involvement occur in continuity without areas of uninvolved mucosa.
e. Backwash ileitis- Inflammation involving 1-2 cm of ileum.
f. Mucosa has fine granular surface like sand paper in mild Inflammation. In more severe inflammation mucosa is hemorrhagic, edematous and ulcerated.
g. The disease process is limited to mucosa and superficial sub mucosa except in fulminant disease.
h. Pseudopolyp- due to epithelial regeneration in long standing disease.
i. Toxic mega colon- Bowel wall become very thin and the mucosa is severely ulcerated.
j. Cryptitis is present leading to crypt abscess, and crypt distortion.