What causes Swiss cheese appearance in small bowel on imaging?
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Answer:
Multiple mucosal defects and channels due to chronic transmural inflammation and ulceration in Crohn disease.
Why is it called so?
The sign resembles Swiss cheese (e.g., Emmental), which contains numerous holes, corresponding to the multiple punched-out mucosal defects and fistulous channels visible on imaging.
Pathophysiology
Repeated cycles of inflammation, deep ulceration, and healing in Crohn disease lead to formation of multiple aphthous and linear ulcers that penetrate the mucosa, creating defects and interconnecting fistulous tracts or channels that appear as discrete lucencies amidst thickened bowel wall.
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