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(I) IBD

(I) IBD. CROHN DISEASE (granulomatous colitis) ULCERATIVE COLITIS. (I) IBD. COMMON FEATURES IDIOPATHIC DEVELOPED COUNTRIES COLONIC INFLAMMATION SIMILAR Rx BOTH have increased CANCER RISK. (I) IBD DIFFERENCES. CROHN (CD) TRANSMURAL, THICK WALL NOT LIMITED to COLON GRANULOMAS

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(I) IBD

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  1. (I) IBD • CROHN DISEASE (granulomatous colitis) • ULCERATIVE COLITIS

  2. (I) IBD • COMMON FEATURES • IDIOPATHIC • DEVELOPED COUNTRIES • COLONIC INFLAMMATION • SIMILAR Rx • BOTH have increased CANCER RISK

  3. (I) IBD DIFFERENCES • CROHN (CD) • TRANSMURAL, THICK WALL • NOT LIMITED to COLON • GRANULOMAS • FISTULAE COMMON • TERMINAL ILEUM OFTEN • SKIP AREAS • “CRYPT” ABSCESSES NOT COMMON • NO PSEUDOPOLYPS • MALABSORPTION • ULCERATIVE(UC) • MUCOSAL, THICK MUCOSA • LIMITED to COLON • NO GRANULOMAS • FISTULAE RARE • TERMINAL ILEUM NEVER • NO SKIP AREAS • “CRYPT” ABSCESSES COMMON • PSEUDOPOLYPS • NO MALABSORPTION

  4. CROHN vs. UC

  5. VASCULAR DISEASES • ISCHEMIA/INFARCTION • ANGIO-”DYSPLASIA”* • HEMORRHOIDS

  6. ISCHEMIA/INFARCTION • HEMORRHAGE is the main HALLMARK of ischemic bowel disease • ARTERIAL THROMBUS • ARTERIAL EMBOLISM • VENOUS THROMBUS • CHF, SHOCK • INFILTRATIVE, MECHANICAL MUCOSAL TRANSMURAL

  7. A P P E N D I X

  8. ANATOMY • Junction of 3 tenia coli, variable in location • All 4 layers, true serosa • Thickest layer is submucosal lymphoid tissue • APPENDICITIS (ACUTE) • MUCOCELE • MUCUS CYSTADENOMA • MUCUS CYSTADENOCARCINOMA

  9. ACUTE APPENDICITIS • GENERALLY, a disease of YOUNGER people • OBSTRUCTION by FECALITH the classic cause but fecaliths present only about half the time • EARLY APPENDICITIS: NEUTROPHILSMucosa, submucosa • NEED NEUTROPHILS in the MUSCULARIS to confirm the DIAGNOSIS • 25% normal rate, usually • Perforationperitonitis the rule, if no surgery

  10. ACUTE APPENDICITIS

  11. Mucus “TUMORS” • Mucocele (common) • Mucinous Cystadenoma (rather rare) • Mucinous Cystadenocarcinoma (rare)

  12. MUCOCELE • COMMON CYST on APPENDIX filled with MUCIN • Can RUPTURE to become: PSEUDOMYXOMA PERITONEII (Jelly Belly)

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