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Crohn Disease : Clinical

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Introduction: Like ulcerative colitis, Crohn disease is a chronic relapsing inflammatory bowel disease that results from inappropriate activation of mucosal immune response of unknown etiology.

Clinical Features: The onset of Crohn disease is insidious in 80% of cases and occurs with intermittent bouts of diarrhea, fever, and abdominal pain. The remaining 20% of patients present with acute symptoms mimicking acute appendicitis or peritonitis.

The symptomatic phase is followed by remissions lasting weeks or months. The relapses are triggered by exposure to physical, emotional, or environmental stimuli. Cigarette smoking is a known risk factor for initiating the disease as well as causing its re-activation.

This specimen of Crohn's colitis shows long, serpentine ulcers along the length of the bowel covered by hemorrhage and exudate. For a detailed discussion of gross pathologic features of Crohn disease, see slides 43-49. Image courtesy of Dr. Jean-Christophe Fournet, Paris, France; humpath.com; Used with permission.

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