Macroscopic examination of surgically resected specimens in inflammatory bowel disease

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Introduction

Inflammatory bowel disease (IBD) exemplified by Crohn’s disease (CD) and ulcerative colitis (UC) describes chronic inflammatory conditions of the gastrointestinal (GI) tract characterized by intermittent relapse and remission. Although the precise etiology remains unclear, it is believed to arise in genetically susceptible individuals exposed to environmental exposures, resulting in an abnormal immune response to the intestinal microbiome. Historically, IBD was considered as diseases of residents from highly affluent Western countries. These notions have been shattered since recent epidemiological studies have demonstrated that the development of IBD is not limited by geographical borders, ethnicity, or socioeconomic status .

Patients with IBD may present with bloody diarrhea, abdominal pain, urgency, tenesmus, fatigue, weight loss, and fever. Since the clinical manifestations are variable and nonspecific, the diagnosis of IBD can be difficult in some cases. The extensive differential diagnosis of IBD varies with the site of involvement and the chronicity of the clinical presentation. It includes but is not limited to ischemic colitis, lymphoma, intestinal tuberculosis (ITB), medication-associated colitis, and infectious colitis.