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Complications of Crohn's disease A variety of immunologically related systemic complications can occur in Crohn's disease, including ulcerations of the tongue, uveitis, and erythema nodosum.

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Crohn's disease Middle aged female with abdominal pain and altered bowel habit This patient had a long history of gastrointestinal symptoms. On this occasion she presented with abdominal pain and altered bowel habit. A barium enema was performed. What does it show, and what is the likely diagnosis? Findings There is a short segment of abnormal descending colon with asymmetrical puckering of the mucosal surface, without stricturing. Note also however that contrast has refluxed into the

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Is a whole mount preparation showing a histologic section of chronic ulcerative colitis with pseudopolyps at the top and a classic case of Crohn's disease of the colon at the bottom. A number of differences are readily apparent. The first obvious difference is that the colonic wall in Crohn's disease is considerably thicker than that in chronic ulcerative colitis. This is for a number of reasons. First of all, the inflammation in Crohn's disease is transmural; that is, it involves all coats of the colonic wall whereas the inflammation in ulcerative colitis is usually limited to the mucosa and submucosa. The collections of chronic inflammatory cells in all levels of the colonic wall, as well as the inflammatory edema and subsequent fibrosis of the submucosa and serosa in Crohn's disease, account forthe increased thickness of the colonic wall. Linear ulcers are present in Crohn's disease as well as in ulcerative colitis, and you can see one in the center of the colonic mucosa in the Crohn's

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Slide 2 The transmural inflammation in Crohn's disease results in a fibrous reparative response in the submucosa and quite often in the serosa. This Trichrome preparation shows a marked increase in fibrous connective tissue (blue) in the submucosa (SM

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Slide 3 Gross-ileum: The fibrous reparative reaction in Crohn's disease causes marked thickening of the bowel wall and stenosis of the lumen (Rubber hose or lead pipe bowel). This is a classic example of Crohn's disease of the terminal ileum showing marked thickening with a loss of pliability of the wall and narrowing of the lumen.`

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Slide 4

This low power view of Crohn's colitis shows mucosal ulceration and transmural inflammation.

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Small intestine, Crohns disease

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