Partial colectomy for diverticular disease

From Libre Pathology
Jump to: navigation, search
Drawing showing sigmoid diverticula. (WC/Anpol42)

Partial colectomy for diverticular disease is a very common procedure. The sigmoid colon is typically afflicited; in that case it can more precisely be labeled sigmoidectomy for diverticular disease.

Introduction

This is a relatively common specimen. Diverticulitis (inflammation of diverticula) and it complications are usually diagnosed by computed tomography (CT).[1]

If the individual has a peritonitis, a (temporary) stoma is created in a surgery known as a Hartmann's procedure.[1]

The pathologist's main tasks in this specimen is:

  1. Confirming and documenting extent of the disease.
  2. Excluding malignancy.

Protocol

Specimen:

  • Length __ cm.
  • Circumference (proximal/one end) __ cm.
  • Circumference (distal/other end) __ cm.
  • Mesentry (maximal): __ cm.

Appearance:

  • Serosal surface: [shiny/hemorrhagic/dull/exudate/adhesions].
  • Mucosa: [unremarkable/granular].
    • Polyps: [none/number - size __ cm, location (to nearest resection margin): __ cm].
  • Number of diverticula (count up to 6, then estimate): [number of diverticula].
  • Wall: [unremarkable/thickened].

Other:

  • Perforation: [not identified/present - location of perforation (to nearest mucosal margin): __ cm, size of performation __ cm].

Representative sections submitted:

  • Proximal mucosal margin.
  • Distal mucosal margin.
  • Diverticula (3-5 blocks).
  • Interdiverticular mucosa (2 blocks).
  • Lymph nodes (2 blocks).

Protocol notes

Alternate approaches

Pathology

See also

Related protocols

References

  1. 1.0 1.1 Schultz, JK.; Yaqub, S.; Øresland, T. (Oct 2016). "Management of Diverticular Disease in Scandinavia.". J Clin Gastroenterol 50 Suppl 1: S50-2. doi:10.1097/MCG.0000000000000642. PMID 27622365.