GPR: 2019 - Week 31

• GPR Quiz
• Answer
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• DDx2

Clinical history

34-year-old male with frequent bloody stools, nausea/vomiting, and abdominal pain despite maximal medical therapy

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Ulcerative colitis Usually involves rectum Extends proximally continuously Can revert to normal mucosa abruptly or gradually Hemorrhagic, granular, friable Can have “cecal patch” (manifestation near the appendiceal orifice)

Pseudomembranous colitis Colonization with C. diff, release of toxins, mucosal damage Yellow-green exudates adherent to the mucosal surface

Crohn's disease Usually no rectum involvement Skip lesions Serosa dull/granular with fat wrapping Thick intestinal wall, narrow lumen, fistulas, linear ulcers Sharp demarcation of uninvolved Cobblestone appearance

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This week's Gross Pathology Roundup was presented by Melissa Krystel-Whittemore, MD on Mon, Jul 29, 2019.