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Related Concept Videos

Inflammatory Bowel Disease III: Crohn's Disease01:25

Inflammatory Bowel Disease III: Crohn's Disease

Crohn’s disease is a chronic, relapsing form of inflammatory bowel disease characterized by segmental, transmural inflammation that can affect any part of the gastrointestinal tract. Its pathogenesis arises from a combination of genetic susceptibility, environmental exposures, epithelial barrier dysfunction, and immune dysregulation. Together, these factors lead to an exaggerated immune response against components of the gut microbiome.Genetic and Environmental InfluencesMultiple genetic...
Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...
Inflammatory Bowel Disease IV: Clinical Manifestations01:20

Inflammatory Bowel Disease IV: Clinical Manifestations

Inflammatory bowel disease (IBD) encompasses two major chronic disorders—ulcerative colitis and Crohn’s disease—each characterized by relapsing episodes of gastrointestinal inflammation. Although they share certain clinical features, their patterns of involvement and manifestations differ in ways that aid diagnosis and guide management.Ulcerative ColitisUlcerative colitis is limited to the colon and rectum and involves continuous inflammation of the mucosal layer. The disease course is marked...
Inflammatory Bowel Disease II: Ulcerative Colitis01:20

Inflammatory Bowel Disease II: Ulcerative Colitis

Ulcerative colitis is a chronic inflammatory disorder of the colon characterized by continuous mucosal inflammation that typically begins in the rectum and extends proximally in a uniform pattern. Its pathogenesis involves a complex interplay of genetic predisposition, immune dysregulation, and environmental influences. These factors converge to impair the colon’s epithelial defenses and promote an exaggerated inflammatory response against luminal contents.Breakdown of the Mucosal BarrierA...
Inflammatory Bowel Disease I: Introduction01:26

Inflammatory Bowel Disease I: Introduction

Inflammatory bowel disease is a group of chronic disorders marked by recurrent inflammation of the gastrointestinal tract due to an abnormal immune response against gut microflora. This leads to tissue damage. The two main forms are Crohn’s disease and ulcerative colitis.Crohn’s DiseaseCrohn’s disease is a relapsing inflammatory disorder that can affect any part of the GI tract, from the mouth to the anus. It involves all layers of the bowel wall (transmural) and shows “skip lesions” in which...
Chronic Inflammation: Introduction01:12

Chronic Inflammation: Introduction

Chronic inflammation is a prolonged, dysregulated immune response that persists for weeks to years when the inciting stimulus is difficult to eradicate or when self‑antigens drive ongoing reactivity. Morphologically, it is defined by mononuclear cell infiltration, progressive tissue destruction, and concurrent attempts at healing via angiogenesis and fibrosis. Compared with acute inflammation, edema is less prominent while cellular infiltration predominates; triggers include persistent...

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The connective tissue changes of Crohn's disease.

Golda Shelley-Fraser1, Neil R Borley, Bryan F Warren

  • 1Gloucestershire Cellular Pathology Laboratory Department of Colorectal Surgery, Cheltenham General Hospital, Cheltenham, Gloucestershire, UK.

Histopathology
|October 20, 2011
PubMed
Summary

Connective tissue changes, including fat-wrapping, are key to chronic Crohn's disease (CD) pathology. These changes, often overlooked, are crucial for understanding and diagnosing long-term CD.

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Area of Science:

  • Gastroenterology
  • Pathology
  • Surgical Pathology

Background:

  • Crohn's disease (CD) is primarily characterized by inflammation.
  • Connective tissue alterations in CD, particularly fat-wrapping, are significant but understudied.
  • Fat-wrapping is a pathognomonic feature of CD, vital for surgical diagnosis.

Purpose of the Study:

  • To highlight the importance of connective tissue changes in Crohn's disease pathology.
  • To emphasize the role of fat-wrapping and other connective tissue alterations in chronic CD.
  • To advocate for increased attention to these features by clinicians, pathologists, and researchers.

Main Methods:

  • Pathological examination of Crohn's disease tissues.
  • Analysis of the relationship between inflammatory cells and adipocytes.
  • Identification and characterization of fibrosis, muscularization, neuronal, and vascular changes.

Main Results:

  • Fat-wrapping, resulting from adipocyte hyperplasia and interplay with inflammatory cells, is pathognomonic for CD.
  • Transmural inflammation is closely associated with fat-wrapping.
  • Fibrosis, muscularization, neuronal, and vascular changes are distinctive and specific connective tissue alterations in chronic CD.

Conclusions:

  • Connective tissue changes are integral to the long-term pathology of Crohn's disease.
  • These changes, including fat-wrapping, fibrosis, and vascular/neuronal alterations, can aid in diagnosing even 'burnt-out' CD.
  • Further research and clinical attention are warranted for these underappreciated aspects of CD.