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Inflammatory Intestinal Diseases

Inflammatory Intestinal Diseases. Ulcerative Colitis. Unknown etiology Mucosal inflammation and ulceration in the large intestine Always involves the rectum Early; Widespread fuzzy, serrated ulcerations Late; Rigid tube appearance, ‘lead pipe’ Complications; Toxic megacolon , carcinoma.

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Inflammatory Intestinal Diseases

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  1. Inflammatory Intestinal Diseases

  2. Ulcerative Colitis • Unknown etiology • Mucosal inflammationand ulceration in the large intestine • Always involves the rectum • Early; Widespread fuzzy, serrated ulcerations • Late; Rigid tube appearance, ‘lead pipe’ • Complications; Toxic megacolon, carcinoma

  3. Ulcerative Colitis • Fine serrated margins • Represents mucosal ulcerations

  4. Ulcerative Colitis • Close up serrations

  5. Ulcerative Colitis • Diffuse involvement with ulcerations

  6. Ulcerative Colitis • Extensive descending colon involvment with deep ulcerations of mucosa.

  7. Ulcerative Colitis • Fine serrations in the sigmoid colon.

  8. Ulcerative Colitis • AP film from air contrast barium enema • Acute disease • Smooth surface distal colon and rectum or fine serrations • Loss of haustra • Some narrowing

  9. Ulcerative Colitis Chronic • Areas of marked narrowing • Shortening of the colon • Abnormal smoothness • No haustrations

  10. Crohn’s Disease • Unknown etiology • Transmural process • Any part of alimentary tract • Mostly terminal ileum, proximal colon, may affect the duodenum

  11. Crohn’s Disease • Cobblestone appearance (edema with criss-crossed ulcers) • Skip areas of normal bowel • Complications- obstruction, fistulas and abscess

  12. Regional Enteritis • Separation of loops • Skip areas of more normal appearing small intestine • Areas of edematous small intestine • Areas of narrowing

  13. Regional Enteritis • Marked narrowing of the terminal ileum

  14. Crohn’s Disease • Spot films of terminal ileum • Areas of narrowing separated by areas of more normal bowel • Separation of loops • Fistulas (arrow)

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