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4.2.2 Acute Ileitis

Proliferative Haemorrhagic Enteropathy (PHE) affects the terminal ileum and proximal colon, (see pict. 4.2.2 a) with a thickened, swollen intestine, mucosal thickening and serosal oede­ma. This is very similar to that seen in severe chronic Ileitis. In the acute form, the additional change is that the lumen of the ileum and colon contains one or more, large formed blood clots (see pict. 4.2.2a). These are often mixed with other bloody fluids, fibrin or food particles. The rectum may contain black, tarry faeces, also with mixed blood and digest, since the large intestinal convolute is filled with blood (see pict. 4.2.2 b). Single pin point haemorrhages are uncommon and mucosal ulcerations are rare.

Picture 4.2.2 a (by J. Pohlenz)
Serosal oedema (upper right corner) in colon with turgid, thickened wall; blood clot admixed with some fibrin in colonic lumen adherent to irregularly thickened ridges of mucosal folds.

Picture 4.2.2 a (by J. Pohlenz)
Serosal oedema (upper right corner) in colon with turgid, thickened wall; blood clot admixed with some fibrin in colonic lumen adherent to irregularly thickened ridges of mucosal folds.

Picture 4.2.2 c (by J. Pohlenz)
Dilated colonic loops filled with blood, from a gilt, which died from Lawsonia intracellularis infection.

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