•Large bowel, cecum
•Flask-shaped ulcers
•Brain-liver abscesses
Pseudomembraneous Colitis
•Due to antimicrobials
•Clostridium difficile
Ulcerative Colitis
•Young adults
•Large bowel
•Crypts abscess
•Pseudopolyps
•Mucosal/submucosal inflammation
Crohn’s Disease
•Jewish young adults (20-30)
•Granulomas
•Transmural inflammation
•Cobblestones
•String sign
•Fistulas
Villous Adenoma
•Cauliflower shape
•Rectum
•Protein losing enteropathy
Tubular Adenoma
•Colonal lesions
•Most common
•Small and pedunculated
Adenocarcinoma
•Iron deficiency anemia
•Apple-core lesions
•CEA elevation in serum
Meckel’s Diverticulum
•Vitelline duct remnant
•Intussusception and volvulus
•Distal small intestine
Colonal Carcinoma
•Men 60-70
•Adenocarcinoma
•CEA antigen
Hirschsprung’s Disease
•Congenital megacolon
•Lack of ganglion cells (Meissner and Auerbach)
•No meconium
•Colonic dilatation proximal to aganglionic segment
Familial Polyposis
•100% risk of malignant transformation
•Autosomal dominance
8. LIVER AND PANCREAS
Hepatitis B
•Parenteral, sexual and vertical transmission
•Acidophil (Councilman) body
•Ground glass hepatocytes
•Apoptosis
•Hepatocellular carcinoma
•ALT > AST
Hepatitis A
•Fecal-oral transmission
•Direct hyperbilirubinemia
•Incubation: 14 - 21 days
•ALT > AST
Hepatitis C
•Blood transfusion
•Proliferative glomerulonephritis
Reye’s Syndrome
•Young children
•Encephalopathy and coma
•Flu-like illness;
•Chicken pox and Influenza
•Aspirin ingestion
•Fatty Liver
Primary Billiary Cirrhosis
•Autoimmune
•Middle-aged women
•Antimitochondrial antibody
•Severe obstructive jaundice
Chronic Passive Congestion
•Right heart failure
•Nutmeg liver
Hepatic Adenoma
•Subcapsular and intraperitoneal hemorrhage
•Oral contraceptives
Hepatocellular Carcinoma
•Most common primary malignancy
•Hepatitis B, cirrhosis
•Aflatoxin B
•Alpha-fetoprotein marker
•Alcoholism
•Low serum albumin
•Increased PT, Ascites
•Wilson disease
Angiosarcoma
•Vinyl chloride
•Thorotrast
•Arsenic
Alcoholic Cirrhosis
•Mallory’s hyaline—cytokeratin filament
•Fatty liver changes
•Focal necrosis
Wilson’s Disease
•Autosomal recessive
•Kayser-Fleischer rings, cornea
•Hepatolenticular degeneration
•Copper accumulation, liver
•Low ceruloplasmin
•Chromosome 13, band q14.3
Hemochromatosis
•Iron absorption defect
•Cirrhosis
•Bronze diabetes
•Steatorrhea
•Skin pigmentation
α-1 Antitrypsin Deficiency
•Barrel-shaped chest
•RT ventricular hypertrophy
•Obstructive pattern
•Panacinar emphysema-lower lobe
•Cirrhosis
Chronic Pancreatitis
•40+ men
•Alcoholism
•Steatorrhea
•Epigastric pain
•High serum amylase and lipase
•Cystic fibrosis
Acute Pancreatitis
•Male
•Alcoholism
•Mid epigastric pain
•Increased Amylase, SGOT, LDH
•Hypocalcemia
•Gall stones
Cholangiocarcinoma
•Intrahepatic