ROSH Gastrointestinal Practice Exam

What is characterized by transmural involvement with a cobblestone appearance in the intestines?

1. Ulcerative colitis

2. Crohn disease

3. Diverticulosis

4. Gastroesophageal reflux disease

The correct answer is: Crohn disease

The condition characterized by transmural involvement with a cobblestone appearance in the intestines is indeed Crohn disease. Crohn disease is a type of inflammatory bowel disease (IBD) that can affect any part of the gastrointestinal tract but is most commonly found in the ileum and the colon. In Crohn disease, the inflammation extends through the entire thickness of the intestinal wall, leading to features such as strictures, fistulas, and abscess formation. The "cobblestone" appearance refers to the distinctive pattern observed during endoscopy or imaging studies, where segments of inflamed mucosa are interspersed with areas of normal tissue. This irregular, segmented, and patchy distribution of lesions is a hallmark of Crohn disease, reflecting its transmural nature. In contrast, ulcerative colitis, another form of IBD, is limited to the mucosal layer of the colon and rectum and typically presents with continuous lesions rather than the patchy distribution seen in Crohn disease. Diverticulosis involves the formation of pouches in the intestinal wall and does not exhibit transmural inflammation or a cobblestone appearance. Gastroesophageal reflux disease (GERD) is related to esophageal acid exposure and would not present with