Crohn's Disease

Epidemiology
*White
*20-30yrs (any age)

RFx
SMOKING!!!

Symptoms
Insid O/S
Abdo pain
Diarr
WL
Perianal disease
Skin tags
Fisulae
Fissures
Abscesses
Appendicitis

Pathology
Sharply delimited & transmural
Mucosal damage & inflammation
Non-caeseating granulomas
Deep fissuring (rose thorn ulcers)
Cobblestoning (islands of residual mucosa surrounded by deep ulcers)
Fat wrapping of mesentery (serosal - the external surface of bowel - inflammation)
Adhesions to another bowel loop/bladder/uterus

Fistulas (fissuring ulcers extend between serosa & bowel loop/bladder/uterus) =
Pneumouria/faecesuria/air or faeces per vagina

Transmural inflamm of muscPp (main muscle coat of bowel) =
Neuromusc Hplasia & thickening of bowel wall =
Stricture =
Sx Tx

Ix
Micro
Full thickness ulceration w/ granuloma formation (50% biopsies)
Lp inflammation & cryptitis (containing Nps)
Crypt abscesses (Nps destroying crypts)

Cx
Increases ColCa x5/6