Liver & GIT
Skip granulomatous lesions are seen in:(AIIMS NOV 09)
a. Most patients have involvement of both small and large intestine( 40-55%).
b. 30-40% have involvement of small intestine alone.
c. 15-25% have involvement of large intestine alone.
d. Rectum is often spared in CD.
e. The most common site of inflammation is terminal ileum.
f. Involvement is segmental with skip areas.
g. CD is a trans mural process.
h. ‘Cobblestone’ appearance is characteristic of CD.
i. Pseudo polyps can occur in CD. But much less frequent than ulcerative colitis.
j. Bowel wall thickens, fibrosed leading to recurrent bowel obstruction.
k. Creeping fat’- Projections of thickened mesentery encase the intestine.
l. Perirectal fistula, abscesses, fissures and stenosis is common.
m. Liver and pancreas are also involved.
n. Non caseating granuloma in all layers of intestinal wall from mucosa to serosa. Granuloma are also seen in lymph nodes, mesentery, peritoneum, liver and pancreas.
o. Aphthoid ulcers and focal crypt abscesses are earliest lesion.