Cobble stoning of colon is seen in :
**Core Concept**
Cobblestoning of the colon refers to a characteristic mucosal appearance seen in celiac disease, characterized by a mixture of normal and inflamed mucosa, resembling cobblestones. This phenomenon is a result of the immune-mediated injury to the small intestine and its subsequent effect on the colon. The exact pathophysiology involves the abnormal immune response to gluten, leading to inflammation and damage to the intestinal mucosa.
**Why the Correct Answer is Right**
Cobblestoning of the colon is a manifestation of the malabsorption and increased permeability of the gut mucosa, which allows toxins and undigested food particles to cross into the bloodstream, triggering an immune response. The inflammation and damage to the intestinal mucosa can lead to changes in the colon's mucosal appearance, including cobblestoning. This condition is often seen in patients with untreated or poorly managed celiac disease.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because cobblestoning is not a characteristic feature of ulcerative colitis, which typically presents with continuous inflammation of the colon.
**Option B:** This option is incorrect because Crohn's disease can cause cobblestoning-like appearance in the small intestine, but it is not the primary association with cobblestoning of the colon.
**Option C:** This option is incorrect because infectious colitis typically presents with acute inflammation and diarrhea, rather than the chronic changes seen in celiac disease.
**Clinical Pearl / High-Yield Fact**
Cobblestoning of the colon is a rare but classic finding in celiac disease, and its presence should prompt a search for other signs of malabsorption and immune-mediated injury. Patients with celiac disease often present with non-specific symptoms such as diarrhea, weight loss, and fatigue, making it essential to consider this diagnosis in patients with chronic gastrointestinal symptoms.
**Correct Answer: C. Crohn's disease**