Granulomatous lesion is diagnostic of Crohn's disease

The clinical manifestation of the fistula: - enteroenteric fistulas may be asymptomatic or present as a palpable mass

- enterovesical fistulas lead to recurrent urinary tract infections, often with multiple organisms, and to pneumaturia - fistulas to the retroperitoneum may lead to psoas abscesses or ureteral obstruction with hydronephrosis

- enterovaginal fistulas may present with passage of gas or feces through the vagina

- enterocutaneous fistulas can cause bowel contents to drain to the surface

The clinical manifestation of the fistula:

-perianal pain

-drainage from large skin tags

-anal fissures

-perirectal abscesses

-anorectal fistulas

Ileocolitis

-right lower quadrant pain and diarhhea

-palpable mass, fever and leucocytosis

-pain is colickly and relieved by defecation

Jejunoileitis

-inflammatory disease is associated with loss of digestive and absorptive surface

Colitis and perianal disease

- low grade fever, malaise, diarrhea, crampy abdominal pain, sometimes hematochezia

- pain is caused by passage of fecal material through narrowed and inflamed segments of large bowel

Gastroduodenal disease

- nausea, vomiting, epigastric pain

- second portion of duodenum is more commonly involved than the bulb

IBD is associated with variety of

extraintestinal menifestation.

Almost one-third of the patients have at least one.

Dermatologic

1. Erythema nodosum occurs in up to

15% of CD patients and 10% of UC patients.

The lesions of EN are hot, red, tender nodules measuring to 5 cm in diameter and are found on the anterior surface of the ankles, calves, thighs and arms.

2. Pyoderma gangrenosum is seen in

1 to 12% of UC patients and is less common in CD colitis. PG may occur years before the onset of bowel symptoms.

Lesions are common on the dorsal surface of the feet and legs but may

Rheumatologic

Peripheral arthritis developes in 15 to 20% of IBD patients, is more common in CD.

It is asymmetric, polyarticular and migratory. Most often affects large joints of the upper and lower extremities.

Ankylosing spondylosis occurs in 10% of IBD.

Sacroilitis is symetrical, occurs equally in UC and CD, often asymptomatic