Skip granulomatous lesions are seen in-

Ans. is 4b' i.e., Crohn's diseaseSkip lesions are characteristic of Crohn's disease.o This pt. is suffering with Crohn's ds.o The characterstics of Crohn's ds and their comparison with Ulcerative colitis are given -Once you know them the answer becomes obvious.FeaturesUlcerative colitisCrohn's dso Rectal involvemento Distribution of lesionso Mucosal appearanceo Associated ileal>90%ContinuousFriable, diffusely involved 10%, mild, terminal ileal InflammationRectum spared in > 50%Skip lesionsCobblestone appearance 50% have combined ileal and colonic involvement.o Perianal abcess, fistulaso Intestinal strictures & obstructiono Intestinal fistulaso Fissures (Radiological)o Toxic megacolono Extraintestinal Manifestation -RareNot seen Not seen Not seenRare but more than crohns dsCommonCommonCommonCommonVery rarey Sclerosing pericholangitisy Uveitis & Arthritisy Pyoderma gangrenosumCommonCommonCommonRareCommonRarePathological Features o Depth of inflammationo Creeping mesentric fato Fibrous thickening of wallo Pseudopolypso Granulomaso Dysplasiao CarcinomaMucosalNot seenCommon (lead pipe)CommonNot seenCommon10%TransmuralCommonRareRareCommonRareRare