Creeping fat is a feature of-

Ans. is 'a' i.e., Crohn's disease Features of CD o Ileum is involved most commonly; therefore, CD is also known as terminal ileitis. o In the affected segment, mesentric fat wraps around the bowel surface --> creeping fat. o The intestinal wall is rubbery and thick, as a consequence of edema, inflammation, fibrosis, and hyperophy of the muscularis propria --> lumen is almost always narrowed --> string sign on barium meal. o A classic feature of CD is the sharp demarcation of diseased bowel segments from adjacent uninvolved bowel. When multiple bowel segments are involved, the intervening bowel is normal --> skip lesions. o There are serpentine linear ulcer along the axis of bowel. o As the intervening mucosa tends to be relatively spared, the mucosa acquires a coarsely textured --> Cobblestone appearance. o Narrow fissures develop between the folds of the mucosa. o Fissures can penetrate deeply through the bowel wall and leading to bowel adhesions and serositis. o Fuher extension of fissures leads to fistula or sinus tract formation. o There is transmural inflammation affecting all layers of bowel wall. Sarcoid like noncaseating granulomas may be present in all tissue layers. o Neutrophilic infiltration into the crypts results in formation of crypt abscess. o Fibrosis of the submucosa, muscularis propria, and mucosa enentually leads to stricture fromation. o There is an incrcased incidece of cancer of GIT in patints with long- standing CD, but the risk of cancer in CD is considerably less then in patients with chronic UC. o Screening test is presence of anti-Saccharomyces cerevisae antibody (ASCA). Antibody formation is common against cell wall of yeast, Saccharomyces cerevisae in patients of CD. o To confirm the diagnosis endoscopy is done so that direct visualization of the lesion can be done and even a biopsy can be done if needed.