Partial colectomy for diverticular disease

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).

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

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 (1 or 2 blocks). ‡

Protocol notes

‡ The Royal College of Pathologists (UK) recommends submitting lymph nodes in benign resection.

Pathology

• 

  Diverticular disease.

See also

Related protocols

• Lower anterior resection for cancer.