Crohns


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  • Clinical

    • female > male
    • age: peaks at 20-30, 60-70
    • chronic, relapsing diarrhea
    • associations: familial
    • labs: ASCA+, pANCA-

  • Gross

    • erosions, serpigenous ulcers, cobblestoning
    • skip-lesions
    • strictures, fissures, fistulas
    • can be anywhere in GI tract

  • Histology

    • IBD features
      • erosions, ulcerations
      • crypts: crypt dropout, cryptitis, crypt abscess
      • fibrosis
    • Crohn features: chronic inflammation, transmural, poorly-formed granuloma, fistulas

  • Ddx

  • Signout

    • biopsy
      • moderate/severe chronic active colitis/enteritis
      • no dysplasia or viral cytopathic effect identified
      • Comment: these findings could be consistent with Crohn's disease in the appropriate clinical setting
    • resection
      • moderate/severe chronic active colitis/enteritis
      • transmural lymphoid aggregates with occasional poorly formed granuloma
      • ___ other IBD and Crohn specific features
      • consistent with history of Crohn disease
      • surgical margins viable and uninvolved
      • no dysplasia or viral cytopathic effect identified
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