Crohn's disease in PhD program.pptx lecture

Crohn's disease lecture

1. Facing Terminal Ileitis : Going Beyond Crohn's Disease اشراف :- أ.د هدى باقر أعداد طالبة الدكتوراه: أسماء جمعة

2. Introduction

3. Crohn's disease:

4. Terminal Ilietus and Crohn’s Disease Researchers have looked closely at the connection between terminal ileitis and Crohn’s disease and found limited evidence that terminal ileitis leads to Crohn’s. One group of researchers examined the progression between the two conditions and found that terminal ileitis without a history of inflammatory bowel disease rarely progresses to Crohn’s disease, with only 5% of their cases

5. Cont.

6. Crohn's disease: Crohn’s disease is a type of inflammatory bowel disease (IBD). People with Crohn’s disease experience inflammation in their gastrointestinal tract, most commonly in the small and large intestines. An  autoimmune disorder  is when the body’s immune system mistakenly attacks healthy cells of the body. This often results in  inflammation .

7. symptoms

8. Causes

9. 1. Meckel’s diverticulum (MD) represents the most common congenital anomalies of the digestive tract that occurs in the gastrointestinal tract, reaching an incidence of 2-4% in the general population, although most patients are asymptomatic . 

10. 2. Use of NSAIDs Aspirin and NSAIDs are related to the reduction of colorectal adenoma and cancer risk but on the other hand, it is also related to injury of the gastrointestinal mucosal. These drugs are mainly involved in the inhibition of cyclooxygenase or prostaglandin-endoperoxide synthase enzymes.

11. 3. Behcet’s disease (BD) BD is a multi-systemic inflammatory condition with unknown etiology and presence of a chronic recurrent clinical course characterized by repeated oral and genital ulcerations, arthritis, vasculitis, ocular lesions, skin manifestations, gastrointestinal involvement. Intestinal BD may affect 3-60% of patients

12. 4. Intestinal infections

13. 5. Malignant diseases T he most common malignancy lesions are adenocarcinoma, gastrointestinal stromal tumors (GIST), carcinoids or lymphomas. Malignant involvement of the ileum, in almost half of the cases, refers to lymphoma.

14. 6. Eosinophilic Gastroenteritis ( EG) Eosinophilic gastrointestinal disorders may occur in adults and consist in two types known as EG, that occur due to pathological eosinophile infiltration (without known causes of eosinophilia such as parasitic infection, malignancy, and drug reaction) in the gastrointestinal wall

15. Diagnosis Contrast X-rays Computerized tomography (CT scan) Leukocyte scintigraphy (white blood cell scan) Endoscopy (includes colonoscopy) Endoscopic ultrasound Magnetic resonance imaging (MRI) Biopsy  

16. Complications Bowel obstruction. Ulcers Fistules Anal fissure Malnutrition Colon cancer

17. Differences between Crohn’s disease and Ulcerative colitis Crohn's Disease Ulcerative Colitis Most common sites Terminal ileum Rectum Distribution Mouth to anus Rectum to colon “back-wash” ileitis Spread Discontinuous / “skip” Continuous Gross features Focal aphthous ulcers with intervening normal mucosa Linear fissures Cobblestone appearance Thickened bowel wall “Creeping fat” Extensive ulceration Pseudopolyps Endoscopic findings Discontinuous lesions, cobblestone, aphthous and linear ulceration, strictures Continuous lesions, Pseudopolyps Histological findings Transmural inflammation Mucosal / submucosal inflammation

18. Inflammatory bowel divided into Ulcerative colitis and Crohn's disease . Terminal ileitis is a part of Crohn's disease the differential diagnosis between them through biopsy. an individual approach is necessary to differentiate from the other conditions once the correct diagnosis is crucial for the immediate therapeutic approach and recovering of the patient