Gastrointestinal Pathology, Set 1

For each of the following patients, select the most likely pathologic finding:

1. A 47-year-old man has mid-abdominal pain for the past month. He has no hematemesis, nausea, or vomiting. On upper GI endoscopy, three sharply demarcated, shallow ulcerations ranging from 1 to 1.5 cm in size are seen in the first portion of the duodenum:

2. A 5 month old baby has irritability and abdominal distension with lack of bowel movements. There is absence of ganglion cells on biopsy of the colon at 6 cm above the anal verge:

3. A 40-year-old woman with a history of chronic alcoholism suddenly has an episode of severe hematemesis:

4. A 30-year-old man has abdominal pain for several weeks along with a low volume diarrhea. Physical examination reveals that bowel sounds are present. There are no distinct areas of tenderness and no masses. A perirectal fistula is noted. On colonoscopy, there are irregular areas of mucosal erythema with ulceration involving the rectum and the splenic flexure. Biopsies of the colon at 10 cm and 60 cm show extensive mucosal inflammation along with small granulomas:

5. A 45-year-old woman has a chronic, watery diarrhea. Stool cultures are negative, and a stool for ova and parasites is negative. The stool is negative for occult blood:

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