The gross pathology of inflammatory bowel disease

Inflammatory bowel disease is a broad term that describes conditions with chronic or recurring immune response, and inflammation of the gastrointestinal tract. The two major types are Crohn's disease and ulcerative colitis. Considering the evaluation of inflammatory bowel disease requires a multidisciplinary approach, gross pathologic examination represents an integral component in its diagnosis and classification. The purpose of this review is to address the following: (1) describe the main gross findings of inflammatory bowel disease that facilitate discrimination between Crohn's disease and ulcerative colitis; (2) discuss atypical/non-classical presentations of inflammatory bowel disease; (3) highlight the importance of gross inspection in detecting and sampling suspicious areas for dysplasia and/or malignancy in the setting of inflammatory bowel disease; and (4) offer practical guidelines for grossing inflammatory bowel disease specimens.