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linear ulceration; stricture formation; non-caseating granulomas in bowel
Crohn's
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bowel inflammation limited to mucosa
ulcerative colitis
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bowel inflammation that is transmural
Crohn's
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most likely complication of diverticulosis
diverticulitis: pericolic abscess
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foul-smelling stool means
malabsorption of fat. Bacteria needed to digest the fat for you.
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Why do celiac patients get bone/knee pains?
They're not absorbing calcium.
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Why are celiac patients anemic?
They're not absorbing iron.
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celiac susceptibility to cancer
T-cell lymphoma, small bowel adenocarcinoma
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test for celiac
tissue transglutaminase (TTG) Ab is sensitive; anti-endomysial Ab is specific
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inflammatory bowel disease (2 types)
Crohn's, ulcerative colitis
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Where does Crohn's occur?
anywhere from anus to terminal ileum.
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Gross lesions in Crohn's resemble
Cobblestones. Skipping patches of inflammation/ulcers.
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Where does UC occur?
starts in anus, removes to rectum. Ulceration is continuous.
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inflammation from colon that travels to ileum
backwash ileitis
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we blame diverticulosis on…
a diet lacking fiber
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benign colonic polyps
hyperplastic polyps, probably in response to inflammation. Benign.
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villous adenoma
bigger than tubular adenoma, high propensity to develop colon cancer
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tubular adenoma
colon polyp with small chance of developing colon cancer
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familial adenomatous polyposis under microscope
tubular or villous adenoma
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chance of colon cancer in FAP; what you do about it
nearly 100%, scope often looking for dysplasia
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basis for FAP?
APC gene… adenomatous polyposis colon. Two alleles, one from each parent, defective allele is passed down. THEN, patient develops second mutation in GI tract. Two-hit hypothesis.
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gross appearance of tubular adenoma
raspberries
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gross appearance of villous adenoma
cauliflower
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Peutz-Jeghers syndrome is characterized by
polyps all along digestive tract. Arborized hamartomas. All benign components.
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skin presentation of Peutz-Jeghers syndrome
densely pigmented spots on mucosal surface
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tarry, black stool indicates
upper GI bleed
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bright red bloody stool indicates
lower GI bleed
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most common cause of colon bleeding
angiodysplasia - abnormal formation of blood vessels around wall of colon
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metastatic carcinoma to the colon can be treated with
EFGR inhibitor
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right-sided colon cancer presentation
anemia, weight loss, abdominal pain
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left-sided colon cancer presentation
causes obstruction, detected earlier, napkin-ring constriction
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prognosis of right-sided vs. left-sided colon cancer
left-sided is usually detected earlier
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colon cancer that only involves mucosa
Stage 1
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colon cancer that hits muscularis externa
Stage 2
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colon cancer that goes through muscularis externa
Stage 3
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colon cancer that invades down into adventitia
Stage 4
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