This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pediatrics
Skip granulomatous lesions are seen in ? 
Select and explain. 
A. Ulcerative colitis, B. Crohn's disease, C. Whipple's disease, D. Reiter's disease
B: Crohn's disease
Answer: B: Crohn's disease 
Explanation: 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.