The relationship between inflammatory and serosal connective tissue changes in ileal Crohn's disease: evidence for a possible causative link
✍ Scribed by Borley, Neil R.; Mortensen, Neil J.; Jewell, Derek P.; Warren, Bryan F.
- Publisher
- John Wiley and Sons
- Year
- 2000
- Tongue
- English
- Weight
- 193 KB
- Volume
- 190
- Category
- Article
- ISSN
- 0022-3417
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✦ Synopsis
The relationship between the gross connective tissue and in¯ammatory changes in ileal Crohn's disease remains unclear. This study investigated 20 patients undergoing ileal resection for Crohn's disease and 20 normal controls. The specimens were blocked in 1 cm serial sections and fully examined, including fresh morphometry and documentation of a range of pathological features. Pathological features of disease showed uniform distributions within affected segments, although specimens showed different patterns and severity of af¯iction. Serosal fat wrapping (FW) was present in all cases and was signi®cantly greater than normals [mean 63.5% (SD 27.8) vs. 21.0% (6.4), p<0.001], as was mesenteric thickening (MTh) [mean 18.0 mm (SD 11.1) vs. 5.9 mm (2.2), p<0.001]. The extent of FW correlated signi®cantly with the degree of acute and chronic in¯ammation (r s =0.32 and 0.23 respectively, p<0.01), particularly the extent of transmural in¯ammation in the form of lymphoid aggregates (r s =0.35, p<0.01). MTh did not correlate with any features studied. These ®ndings support the hypothesis that serosal connective tissue changes in Crohn's disease are related to the local effects of underlying chronic in¯ammatory in®ltrates. Full thickness, radial samples from a grossly affected area are representative of the histopathological features present in a diseased segment as a whole.