Question

Place the pathophysiologic features of Crohn disease in the correct sequence.

1) Bowel lumen appears as 'cobblestones'
2) Local obstruction and abscess development
3) Fibrotic changes in the bowel wall
4) Presence of inflammatory aphthoid lesion

Answer 1

The pathophysiologic features of Crohn's disease occur in a specific sequence. Initially, there is the presence of inflammatory aphthoid lesions, followed by the characteristic appearance of the bowel lumen as 'cobblestones'. Fibrotic changes then occur in the bowel wall, leading to local obstruction and abscess development.

Step-by-step explanation:

1. Presence of inflammatory aphthoid lesion: This is one of the early pathophysiologic features of Crohn's disease. It refers to the presence of small, shallow ulcers in the lining of the intestines.
2. Bowel lumen appears as 'cobblestones': As the disease progresses, the inflammation leads to thickening of the intestinal wall. This results in a characteristic appearance of the bowel lumen, resembling cobblestones.
3. Fibrotic changes in the bowel wall: Over time, the chronic inflammation causes fibrosis, or the formation of scar tissue, in the bowel wall. These changes can lead to strictures and narrowing of the intestines.
4. Local obstruction and abscess development: As the disease continues to progress, the fibrotic changes and strictures can lead to the development of obstructions in the bowel. These obstructions can cause pain, bloating, and can lead to the formation of abscesses in the surrounding tissues.