Which of the following is the earliest change in intestine which occurs in Chron&;s Disease.
Early Crohn&;s Disease is a Mucosal disorder. The earliest changes of Crohn&;s disease are aphthous erosions or ulcers, which can be detected by barium examining or endoscopy. The earliest lesions are aphthous ulcerations and focal crypt abscesses with loose aggregations of macrophages, which form non-caseating granulomas in all layers of the bowel wall- Harrison Sequence of changes in Crohn&;s disease: Early Crohn&;s disease is a Mucosal Disease: Early Crohn&;s Disease is a Mucosal Disorder (Later involves the submucosa and becomes transmural) The earliest changes of Crohn&;s disease are aphthous erosions or ulcers, which can be detected by barium study. These initial changes typically occur in the mucosal lymphoid tissue. In more active disease (As the inflammatoy process worsens), aphthous lesions tend to coalesce and deepen, forming stellate or bear-claw-shaped ulcers. With progression of disease, stellate ulcerations fuse longitudinally and transversely outlining areas of uninvolved mucosa give rise to a cobblestone appearance (demarcate islands of mucosa that frequently are histologically normal). This &;cobblestone&; appearance is characteristic of CD, both endoscopically and by barium radiography. With progression of disease the disease eventually becomes transmural: Serosal and mesenteric inflammatory promotes adhesions and fistula formation. The bowel wall thickens and becomes narrowed and fibrotic, leading to chronic, recurrent bowel obstructions. Projections of the thickened mesentery encase the bowel ("creeping fat") Although Pseudohyperophy are typical of Ulcerative colitis, they may also be seen in Crohn&;s disease: Inflammatory Pseudohyperophy representing isolated islands of regenerating mucosa can also form in CD (as in UC). Pseudopolyps represents areas of inflamed and regenerating mucosa that project above the level of the surrounding mucosa. Ref: Harrison&;s 19th edition Pgno: 1952
Aphthous ulcer
Longitudinal ulcer
Cobble stone
Transverse ulcer
G.I.T