Gastrointes*nalandLiverPathologyKris*neKra5s,M.D.

GIPathologyOutline

•  Esophagus•  Stomach•  Intes*ne•  Liver•  Gallbladder•  Pancreas

GIPathologyOutline

•  Esophagus•  Stomach•  Intes*ne•  Diver*culosis•  Inflammatoryboweldisease•  Carcinoma

•  Mucosa/submucosaherniatesthroughmusclewall

•  Olderpa*ents,lowfiberdiet

•  Sigmoidcolon

•  Asymptoma*cunlessinfected(“diver*culi*s”)

Diver*culosis

Diver*culosis

Diver*culosis

CrohnDisease•  Anywhere

•  Patchy

•  Transmural

•  Poorresponsetosurgery

•  Increasedriskofcancer

Ulcera*veColi*s•  Colononly

•  Con*nuous

•  Superficial

•  Goodresponsetosurgery

•  Increasedriskofcancer

InflammatoryBowelDisease

Crohndisease Ulcera*vecoli*s

•  Common!50%ofpeople>60.

•  Benignglands;maybecomedysplas*c

•  Moredangerouswhen:•  Large(>1cm)•  Villousarchitecture•  Severelydysplas*c

Adenoma

Tubularadenomaofcolon

Villousadenomaofcolon

Dysplas*c(L)vs.normal(R)epithelium

•  Almostalwaysarisesinadenomatouspolyp

•  Diet:lowfiber,highfat,lotsofrefinedcarbs

•  Symptoms:•  silentforyears•  fa*gue,weakness,iron-deficiencyanemia•  occultbleeding,crampypain

•  5yearprognosis:4%(stage4)-90%(stage1)

ColonCarcinoma

Coloncarcinoma

Coloncarcinoma