This portion of terminal ileum demonstrates the gross findings with Crohn's disease.

Though any portion of the gastrointestinal tract may be involved with Crohn's disease, the small intestine--and the terminal ileum in particular--is most likely to be involved. The middle portion of bowel seen here has a thickened wall and the mucosa has lost the regular folds. The serosal surface demonstrates reddish indurated adipose tissue that creeps over the surface. Serosal inflammation leads to adhesions. The areas of inflammation tend to be discontinuous throughout the bowel. The endoscopic appearance with colonoscopy, demonstrating mucosal erythema and erosion, is seen below

This is another example of Crohn's disease involving the small intestine. Here, the mucosal surface demonstrates an irregular nodular appearance with hyperemia and focal superficial ulceration.

Cohn's disease is characterized by transmural inflammation. Here, inflammatory cells (the bluish infiltrates) extend from mucosa through submucosa and muscularis and appear as nodular infiltrates on the serosal surface with pale granulomatous centers.

This gross appearance is characteristic for ulcerative colitis. The most intense inflammation begins at the lower right in the sigmoid colon and extends upward and around to the ascending colon. At the lower left is the ileocecal valve with a portion of terminal ileum that is not involved. Inflammation with ulcerative colitis tends to be continuous along the mucosal surface and tends to begin in the rectum. The mucosa becomes eroded, as in this photograph, which shows only remaining islands of mucosa called "pseudopolyps". The ileocecal valve is seen at the lower left. Just above this valve in the cecum is the beginning of the mucosal inflammation with erythema and granularity. As the disease progresses, the mucosal

erosions coalesce to linear ulcers that undermine remaining mucosa. Colonoscopic views of less severe UC are seen below, with friable, erythematous mucosa with reduced haustral folds.
Inflammatory Bowel Diseases (IBD) Crohn disease Affects small bowel regional enteritis Affects colon - Crohns disease of colon (or granulomatous colitis) Chronic inflammatory disease that causes ulceration of the colonic mucosa Sigmoid colon and rectum Suggested causes Infectious, immunologic (anticolon antibodies), dietary, genetic (supported by family studies and identical twin studies) Symptoms Diarrhea (10 to 20/day), bloody stools, cramping Treatment Broad-spectrum antibiotics and steroids Immunosuppressive agents Surgery An increased colon cancer risk demonstrated Crohn Disease Granulomatous colitis, ileocolitis, or regional enteritis Idiopathic inflammatory disorder; affects any part of digestive tract, from mouth to anus Difficult to differentiate from ulcerative colitis Similar risk factors and theories of causation as ulcerative colitis