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Medicine G.I.T. e8c7e496

All are true regarding Crohn's disease EXCEPT

A
Rectum is spared
B
Continuous lesion visualized in endoscopy
C
Non caseating granulomas
D
Cobblestone appearance
High-Yield Explanation
(B) Continuous lesion visualized in endoscopy[?]Crohn's disease is frequently associated with "skip lesions," discontinuous areas of active disease in the colon and small intestine with intervening segments that appear normal.Skip lesions in a patient with Crohn's disease.(a). Discrete ulcerated lesion in the rectosigmoid region.(b). Normal looking mucosa in the descending colon.(c). Multiple ulcers with loss of vascular pattern in transverse colon.(d). Discrete ulcers in the ascending colon.(e & f). Discrete ulcers in the cecum.[?]Crohn's Disease:oGross:-Earliest lesion, aphthous ulcer to form multiple, elongated, serpentine ulcers along the axis of the bowel.-Skip lesions-Cobblestone appearance-Fissures-Fistula-Creeping fat-Pseudo polyp [?]Chron's Disease:oMicroscopy: characteristic = granuloma with epithelioid giganto cellular cells:-Giant cells + Langerhans cells + Limphocytes (+ plasma cells, Eosinophils and PMN).-Never caseous necrosis = tuberculosis-Same inflammation in regional lymph- nodes.oInflammatory infiltration is found through all strata of the bowel wall.CHARACTERISTIC FEATURES OF CROHN'S DISEASEoA classical feature of Crohn's disease is skip lesions.oA characteristic sign of early disease is focal mucosal ulcers resembling canker sores or Aphthous ulcers.oNarrow fissures develop between the folds of mucosa which leads later to fistula or sinus tract formation.oMucosal inflammation with crypt abscess formation.oChronic mucosal damage and ulceration are seen.oTransmural Inflammation affecting all layers.oNon caseating granulomas and other mural changes with fibrosis and stricture formation.oUlcerative colitis involves the rectum & extends proximally to involve entire colon (Pancolitis).

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