Ulcers of the intestine

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Manoj Madakshira Gopal

Classification Salient features Pathogenesis Gross Histology Complications

Health & Medicine

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

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

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

Gross
Necrotic slough
Rounded edge
Sharp edge

Histopathology
Necrotic slough
Non-specific
inflammtion
Granulation
tissue
Fibrosis

Complications
Bleeding Perforation
Penetration Stenosis
Malignancy

Typhoid ulcer
Salmonella typhimurium
Salmonella paratyphi

Gross
Peyer’s patches
Oval ulcers
Long axis

Histopathology
Aggregates of
macrophages
Typhoid nodules

Tuberculosis ulcer
Mycobacterium tuberculosis
Mycobacterium bovis

Gross
Transverse
ulcers
Short axis
Direction of
lymphatics

Histopathology
Epithelioid cell
granuloma

Complications
Bleeding Perforation
Obstruction

Pseudmembranous colitis
Clostridium difficile

Histopathology
Mushroom /
Volcanic eruption

Complications
Malabsorption
Toxic
megacolon

Histopathology
Inflammation
CMV inclusion

Gross
Continuous
Wide ulcers
Pseudopolyps

Histopathology
Blunting and
distortion of
villi
Cryptitis
Crypt abscess

Complications
Malabsorption
Toxic
megacolon
Carcinoma

Gross
Skip lesions
Serpengious ulcers
Cobblestone

Histopathology
Transmural
Fissure
Granuloma

Complications
Malabsorption Fistula
Strictures Carcinoma

Histopathology
Apoptosis
Intra-epithelial
lymphocytes

Gross
Ulceroproliferative
Rolled up indurated

Histopathology
Irregular glands
Dysplasia

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