Morbus Chron - Morbus Chron Uglavnom su zahvaeni ILEUM i...

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Morbus Chron Uglavnom su zahvaćeni ILEUM i KOLON, ali može bilo koji deo creva. Terminalni ileitis. Regionalni enteritis. Kronova bolest je segmentna upala digestivne cevi (od usta do rektuma), granulomskog tipa, najčešće završnog dela ileuma (mada može zahvatiti i bilo koji drugi deo gastrointestinalnog trakta). Uglavnom je hronična, praćena povremenim pogoršanjima (nekada može i akutno). Javlja se u svakom dobu, najčešće kod mladih muškaraca. Etiologiia : to je autoimunska bolest: visok titar IgA, genetika, povoljan efekat kortikosteroida, inflamacija. Histološki : zid creva je u celini edematozan sa dubokim ulkusima u vidu linearnih fisura, između kojih sluznica ima izgled „kaldrme". Promene su mestimične - „lezije na preskok". Upalni infiltrat. Stvaranje granuloma bez centralne nekroze. Fibroza. Regionalne limfne žlezde su uvećanje, one nikada ne kolokviraju (za razliku od TBC). Granulocitno tkivo sužava lumen creva. Patološki proces zahvata pojedine segmente cevi, a između njih je crevo intaktno! Između crevnih vijuga često se stvaraju srasline, a kasnije i fistule. Zbog promena na terminalnom ileumu, izostaje resorpcija žučnih soli, one prelaze u kolon, iritiraju sluznicu i izazivaju dijareju - HOLOGENA DIJAREJA. Razlikuiu se 3 oblika reeionalnoe enteritisa :
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1.a.1.1.1. Difuzni infiltrativni oblik 1.a.1.1.2. Difuzni granulomski oblik 1.a.1.1.3. Fokalni oblik (najčešće) Klinička slika : nepredvidive egzacerbacije i remisije. Bol u donjem desnom delu trbuha ili ispod pupka. U početku bolesti uzrok je funkcionalni, kasnije organski, zbog opstrukcije creva. Proliv: kašaste stolice (hologene dijareje) - dehidratacija, sniženje Na, K, Mg, Zn.
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