Skip granulomatous lesions are seen in ?: (A) Ulcerative colitis, (B) Crohn's disease, (C) Whipple's disease, (D) Reiter's disease
Answer is B. Ans. is 'b' i.e., Crohn's Disease Features of CD In the affected segment, mesentric fat wraps around the bowel surface --> creeping fat o The intestinal wall is rubbery and thick, as a consequence of edema, inflammation, fibrosis, and hyperophy of the muscularis propria --> lumen is almost always narrowed --> string sign on barium meal. o A classic feature of CD is the sharp demarcation of diseased bowel segments from adjucent uninvolved bowel. o When multiple bowel segments are involved, the intervening bowel is normal --> skip lesions. o There are serpentine linear ulcer along the axis of bowel. As the intervening mucosa tends to be relatively spared, the mucosa acquires a coarsely textured Cobblestone appearance. o Narrow fissures develop between the folds of the mucosa. Fissures can penetrate deeply through the bowel wall and leading to bowel adhesions and serositis. o Fuher extension of fissures leads to fistula or sinus tract formation. o There is transmural inflammation affecting all layers of bowel wall. Sarcoid like noncaseating granulomas may be present in all tissue layers. o Neutrophilic infiltration into the crypts results in formation of crypt abscess. o Fibrosis of the submucosa, muscularis propria, and mucosa eventually leads to stricture formation. There is an increased incidence of cancer of GIT in patients with long-standing CD, but the risk of cancer in CD is considerably less than in patients with chronic UC.