Inflammatory Bowel Disease- Crohns vs UC

Inflammatory Bowel disease

1. Prof. Mamata Guha Mallick Sinha Inflammatory Bowel Disease

2. It is a chronic condition resulting from inappropriate mucosal immune activation. IBD Disorders that comprise IBD

3. Genetic factors Immunologic factors Microbial factors Environmental factors Etiology

4. Pathogenesis

5. Gross involvement of the small intestine alone - 30 % cases. S mall intestine and colon - 40 %. C olon alone - 30%. Crohn’s disease may involve the duodenum, stomach, esophagus , and even mouth, but these sites are uncommon. Crohn’s Disease

6. Multiple well demarcated segmental bowel involvement with intervening uninvolved skip areas. Wall of the bowel – thick hard (hose pipe) Serpiginous ulcers Cobblestone appearance Fissures Crohn’s Disease – Gross Features

7. Gross picture of Crohn’s Disease

8. Transmural inflammatory cell infiltrate. Non caseating granulomas. Patchy ulceration of mucosa. Widening of submucosa . Crohn’s Disease – Microscopic Features

9. Microscopy of Crohn’s Disease

10. Ulcerative colitis involves the rectum and sigmoid colon and may involve the entire colon. Backwash ileitis. Ulcerative Colitis

11. Linear and superficial ulcers Intervening intact mucosa – pseudopolyps Garden hose appearance – thickened muscle layer due to contraction. Ulcerative Colitis – Gross F eatures

12. Gross features of UC

13. Cryptitis Crypt abscesses Crypt distortion and basal plasmacytosis . Marked congestion, dilatation and hemorrhage from mucosal capillaries. Superficial mucosal ulceration. Diminished goblet cells. Areas of mucosal regeneration and muco -depletion of mucosal epithelium. Ulcerative Colitis – Microscopic Features

14. Microscopy of Ulcerative Colitis

15. Complications Crohn’s disease Malabsorption Fistula formation Stricture formation Malignany Ulcerative colitis Toxic megacolon (fulminant colitis) Perianal fistula Carcinoma Stricture formation

16. THANK-YOU