Q) Which of the following is not characteristic of Crohn Disease : * (From AIIMS 2020 November GI)
a) Granular mucosa b) Transmural involvement c) Skip lesions d) Giant cell granuloma
Ans a ) Granular Mucosa- This is a feature of ulcerative colitis ( Table 49-7 Sabiston 20)
The typical gross appearance of ulcerative colitis is hyperemic mucosa.
Friable and granular mucosa is common in more severe cases, and ulceration may not be readily evident. ( Saby 1340)
IN Crohn disease - Microscopically, there are focal areas of chronic inflammation involving all layers of the intestinal wall with lymphoid aggregates. Non-caseating giant cell granulomas are found in 60% of patients and when present clearly allow a confident diagnosis of CD.
Q) Carcinoid syndrome wrong statement is?
a) 40 % have Right heart dysfunction in carcinoid syndrome
b) >1cm in appendix is indication for Right hemi colectomy
c) 30 % jejunoileal carcinoid are metastatic
d) Resection of primary is done in presence of metastatic disease
Q) In Crohns disease of duodenum , patient has a duodenal abscess which is drained. He develops a fistula with ileal communication. Surgery with the least chance of success would be
a. Ileal reaction and duodenal bypass
b. Ileal resection an dudodenal HMplasty c. Ileal freshen and closure d. Duodenum vertical closure