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Some features of Crohn’s Skip lesions Skip lesions Patchy sections of inflamed bowel with sections of normal bowel in between the lesions. Patchy sections of inflamed bowel with sections of normal bowel in between the lesions. Can effect any part of the alimentary tract Can effect any part of the alimentary tract Most common site is the terminal ileum Most common site is the terminal ileum Recurrent episodes can result in fibrosis of lesions Recurrent episodes can result in fibrosis of lesions Lesions are transmural = high risk of fistula formation Lesions are transmural = high risk of fistula formation
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Was it the Was it the enchiladas?enchiladas?
HxHx
Study done for suspected Crohn’s DiseaseStudy done for suspected Crohn’s Disease
Some features of Crohn’sSome features of Crohn’s Skip lesionsSkip lesions
Patchy sections of inflamed bowel with Patchy sections of inflamed bowel with sections of normal bowel in between the sections of normal bowel in between the lesions. lesions.
Can effect any part of the alimentary tractCan effect any part of the alimentary tract Most common site is the terminal ileum Most common site is the terminal ileum Recurrent episodes can result in Recurrent episodes can result in
fibrosis of lesionsfibrosis of lesions Lesions are transmural = high risk of Lesions are transmural = high risk of
fistula formation fistula formation
Is this a skip lesion????
HmmmmmmHmmmmmm
Where is this???
Answer:Answer: Why, that’s the rectum and sigmoid Why, that’s the rectum and sigmoid
colon looking rather unhappycolon looking rather unhappy Looking stenosed most likely due to Looking stenosed most likely due to
recurrent exacerbations that start here. recurrent exacerbations that start here. Rectum? Darn near killed ‘em (insert Rectum? Darn near killed ‘em (insert
pity laugh here)pity laugh here)
Evidence so farEvidence so far Starts in rectosigmoid area and is a Starts in rectosigmoid area and is a
contiguous lesion throughout the contiguous lesion throughout the coloncolon Not looking like CD, eh?Not looking like CD, eh?
Ah HA! What is not involved here?
EvidenceEvidence NOTNOT involving the terminal ileum involving the terminal ileum ContiguousContiguous lesion of the colon lesion of the colon Starting in the rectosigmoid areaStarting in the rectosigmoid area
DDx for patient with DDx for patient with possible Crohn’spossible Crohn’s
(What else immediately (What else immediately popped into your head?)popped into your head?)
Looking for the #1 alternative here…..Looking for the #1 alternative here…..
Yup, UC is correctYup, UC is correct Some features of UCSome features of UC
Contiguous lesion starting at the rectum Contiguous lesion starting at the rectum (>95%) and spreading proximally(>95%) and spreading proximally
Limited to the colonLimited to the colon Recurrent bouts can lead to fibrosis like in CDRecurrent bouts can lead to fibrosis like in CD Incidence is 10-12 per 100,000/yrIncidence is 10-12 per 100,000/yr It likes the white women (30% more It likes the white women (30% more
according to some reports) and is bi modal in according to some reports) and is bi modal in its distribution (15-25 and 55-65), BUT it can its distribution (15-25 and 55-65), BUT it can hit at any time. hit at any time.
QUESTIONS?QUESTIONS? NO?NO? Good. Good. Thank you Thank you
