Classification Salient features Pathogenesis Gross Histology Complications

1. Ulcers of Intestine

2. SLOs
• Classification
• Salient features
– Pathogenesis
– Gross
– Histology
– Complications

3. Ulcer
“Ulcer is a breach in the
continuity of skin,
epithelium or mucous
membrane caused by
sloughing out of
inflammed necrotic
tissue”

4. Intestinal Ulcers
Peptic
• Duodenal
Infection
• Bacterial
• Virus
• Protozoa
Immune
• GVHD
• Crohn
• Ulcerative
Malignant
• Carcinoma

5. Duodenal Peptic Ulcer

6. Pathogenesis

7. Gross
Necrotic slough
Rounded edge
Sharp edge

8. Histopathology
Necrotic slough
Non-specific
inflammtion
Granulation
tissue
Fibrosis

9. Complications
Bleeding Perforation
Penetration Stenosis
Malignancy

10. Typhoid ulcer
Salmonella typhimurium
Salmonella paratyphi

11. Pathogenesis

12. Gross
Peyer’s patches
Oval ulcers
Long axis

13. Histopathology
Aggregates of
macrophages
Typhoid nodules

14. Complications
Bleeding Perforation

15. Tuberculosis ulcer
Mycobacterium tuberculosis
Mycobacterium bovis

16. Pathogenesis

17. Gross
Transverse
ulcers
Short axis
Direction of
lymphatics

18. Histopathology
Epithelioid cell
granuloma

19. Complications
Bleeding Stenosis

20. Amoebic ulcer
Entamoeba histolytica

21. Pathogenesis

22. Gross
Pin –point ulcers
Nodules

23. Histopathology
Flask shaped
ulcer

24. Complications
Bleeding Perforation
Obstruction

25. Pseudmembranous colitis
Clostridium difficile

26. Pathogenesis

27. Gross
Cap lesion
Pseudomembrane

28. Histopathology
Mushroom /
Volcanic eruption

29. Complications
Malabsorption
Toxic
megacolon

30. CMV Colitis

31. Pathogenesis

32. Gross
Erythematous base
Haemorrhagic

33. Histopathology
Inflammation
CMV inclusion

34. Complications
Malabsorption

35. Ulcerative colitis

36. Pathogenesis

37. Gross
Continuous
Wide ulcers
Pseudopolyps

38. Histopathology
Blunting and
distortion of
villi
Cryptitis
Crypt abscess

39. Complications
Malabsorption
Toxic
megacolon
Carcinoma

40. Crohn’s disease

41. Pathogenesis

42. Gross
Skip lesions
Serpengious ulcers
Cobblestone

43. Histopathology
Transmural
Fissure
Granuloma

44. Complications
Malabsorption Fistula
Strictures Carcinoma

45. Graft versus host disease

46. Pathogenesis

47. Gross
Pin point
Haemorrhagic

48. Histopathology
Apoptosis
Intra-epithelial
lymphocytes

49. Complications
Malabsorption Haemorrhage

50. Carcinoma

51. Pathogenesis

52. Gross
Ulceroproliferative
Rolled up indurated

53. Histopathology
Irregular glands
Dysplasia

54. Complications
Obstruction Metastases

55. Summarise

56. Questions