Difference between revisions of "Inflammatory bowel disease"
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===Robbins=== | ===Robbins=== | ||
UC features:<ref name=Ref_PBoD850>{{Ref PBoD|850}}</ref> | UC features:<ref name=Ref_PBoD850>{{Ref PBoD|850}}</ref> | ||
*Mucosal involvement --sometimes submucosa. | *Mucosal involvement -- sometimes submucosa. | ||
*No skip lesions. | *No skip lesions. | ||
*Colon/rectum only. | *Colon/rectum only. | ||
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Example of a superficial granuloma that is non-specific, i.e. this could be UC or CD: | Example of a superficial granuloma that is non-specific, i.e. this could be UC or CD: | ||
*[http://commons.wikimedia.org/wiki/File:Colitis_with_granuloma_low_mag.jpg Colitis with a superficial granuloma ( | *[http://commons.wikimedia.org/wiki/File:Colitis_with_granuloma_low_mag.jpg Colitis with a superficial granuloma (WC)]. | ||
===Kirsch=== | ===Kirsch=== | ||
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====Words of caution==== | ====Words of caution==== | ||
The following may be UC:<ref>RK. 13 December 2010.</ref> | The following may be present in UC:<ref>RK. 13 December 2010.</ref> | ||
*Cecal patch (cecal involvement without pancolitis). | *Cecal patch (cecal involvement without pancolitis). | ||
*Patchy involvement | *Patchy involvement | ||
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*Ileitis - esp. in the context of severe pancolitis; known as ''backwash ileitis''. | *Ileitis - esp. in the context of severe pancolitis; known as ''backwash ileitis''. | ||
*Deep inflammation (in a fissure). | *Deep inflammation (in a fissure). | ||
*Upper GI tract involvement -- see below. | |||
===Upper gastrointestinal tract involvement=== | |||
*The old dogma was upper GI tract = Crohn's disease. | |||
Characteristics of upper GI tract UC:<ref name=pmid20962621>{{cite journal |author=Lin J, McKenna BJ, Appelman HD |title=Morphologic findings in upper gastrointestinal biopsies of patients with ulcerative colitis: a controlled study |journal=Am. J. Surg. Pathol. |volume=34 |issue=11 |pages=1672–7 |year=2010 |month=November |pmid=20962621 |doi=10.1097/PAS.0b013e3181f3de93 |url=}}</ref> | |||
*Most common: | |||
*#Focal gastritis. | |||
*#Mixed basal inflammation and superficial plasmacytosis in the stomach. | |||
*Unique: | |||
**Diffuse chronic duodenitis. | |||
**~ 10% of UC patients. | |||
**~ 40% of UC + colectomy + pouchitis. | |||
====A tabular comparison==== | ====A tabular comparison==== | ||
Gross pathology: | |||
{| class="wikitable" | {| class="wikitable" | ||
| '''Feature''' | | '''Feature''' | ||
| Line 103: | Line 117: | ||
| Strictures | | Strictures | ||
| maybe | | maybe | ||
| no | |||
|- | |||
| Perianal disease | |||
| yes/no | |||
| no | | no | ||
|- | |- | ||
| Rectal involvement | | Rectal involvement | ||
| no | | no | ||
| yes | |||
|- | |||
| Ileal involvement | |||
| yes, classic | |||
| usu. no; seen in pancolitis | |||
|- | |||
| Upper GI tract involvement | |||
| yes | |||
| yes (gaining acceptance) | |||
|- | |||
| Associated with PSC | |||
| ? | |||
| yes | | yes | ||
|- | |- | ||