Difference between revisions of "Colon"

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Colon (view source)

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→‎Diversion colitis: split-out
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==Diversion colitis==
==Diversion colitis==
:''Diversion proctitis'' redirect here.
{{Main|Diversion colitis}}
===General===
*Segment of de-functioned bowel due to surgical diversion, i.e. stoma (ileostomy or [[colostomy]]).
*[[Diagnosis]] dependent on history - '''key point'''.
 
===Gross===
Features:<ref name=pmid9934577/>
*Ulceration - classic.
*Surgical changes, e.g. fibrotic-appearing thickened wall.
**May not be apparent.
 
===Microscopic===
Features:<ref name=pmid9934577>{{Cite journal  | last1 = Edwards | first1 = CM. | last2 = George | first2 = B. | last3 = Warren | first3 = B. | title = Diversion colitis--new light through old windows. | journal = Histopathology | volume = 34 | issue = 1 | pages = 1-5 | month = Jan | year = 1999 | doi =  | PMID = 9934577 }}</ref>
*Follicular lymphoid hyperplasia - '''key feature'''.<ref name=pmid1916687>{{Cite journal  | last1 = Yeong | first1 = ML. | last2 = Bethwaite | first2 = PB. | last3 = Prasad | first3 = J. | last4 = Isbister | first4 = WH. | title = Lymphoid follicular hyperplasia--a distinctive feature of diversion colitis. | journal = Histopathology | volume = 19 | issue = 1 | pages = 55-61 | month = Jul | year = 1991 | doi =  | PMID = 1916687 }}</ref>
**Abundant lymphoid nodules.
*[[Plasma cell]]s and lymphocytes.
*+/-Changes of an active colitis - uncommon:<ref name=pmid2318485>{{Cite journal  | last1 = Ma | first1 = CK. | last2 = Gottlieb | first2 = C. | last3 = Haas | first3 = PA. | title = Diversion colitis: a clinicopathologic study of 21 cases. | journal = Hum Pathol | volume = 21 | issue = 4 | pages = 429-36 | month = Apr | year = 1990 | doi =  | PMID = 2318485 }}</ref>
**Cryptitis.
**Crypt abscesses.
 
Notes:
*May show IBD-like changes.<ref name=pmid16405661>{{Cite journal  | last1 = Yantiss | first1 = RK. | last2 = Odze | first2 = RD. | title = Diagnostic difficulties in inflammatory bowel disease pathology. | journal = Histopathology | volume = 48 | issue = 2 | pages = 116-32 | month = Jan | year = 2006 | doi = 10.1111/j.1365-2559.2005.02248.x | PMID = 16405661 }}</ref>
**IBD should '''not''' be diagnosed on a diverted segment of bowel.
 
DDx:<ref name=pmid20011361>{{Cite journal  | last1 = Thorsen | first1 = AJ. | title = Noninfectious colitides: collagenous colitis, lymphocytic colitis, diversion colitis, and chemically induced colitis. | journal = Clin Colon Rectal Surg | volume = 20 | issue = 1 | pages = 47-57 | month = Feb | year = 2007 | doi = 10.1055/s-2007-970200 | PMID = 20011361 | PMC = 2780148| url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780148/ }}</ref>
*[[Inflammatory bowel disease]] - no stoma.
*[[Ischemic colitis]].
*[[Infectious colitis]].
**[[Pseudomembranous colitis]].
 
====Images====
<gallery>
Image:Diversion_proctitis_-_low_mag.jpg | Diversion proctitis - low mag. (WC/Nephron)
Image:Diversion_proctitis_-_high_mag.jpg | Diversion proctitis - high mag. (WC/Nephron)
</gallery>
===Sign out===
<pre>
SIGMOID COLON, BIOPSIES:
- MILD ACTIVE COLITIS WITH LAMINA PROPRIA FIBROSIS, SEE COMMENT.
- NEGATIVE FOR DYSPLASIA.
 
COMMENT:
No granulomas are identified.  Follicular lymphoid hyperplasia is not identified;
however, there is no definite submucosa present.
 
Diverted segments of bowel can have inflammatory bowel disease-like changes.
 
In the context of a diverted segment of bowel, the findings are compatible with
a diversion colitis.
</pre>
 
<pre>
RECTUM, BIOPSY:
- CHRONIC ACTIVE PROCTITIS WITH FOCAL ULCERATION, CRYPTITIS AND CRYPT ABSCESSES.
- GRANULATION TISSUE.
- NEGATIVE FOR DYSPLASIA.
 
COMMENT:
No lymphoid hyperplasia is present. A small lymphoid aggregate is present.
Architectural distortion is present.
 
In the context of a diverted segment of bowel, the findings are compatible with
a diversion colitis.
</pre>


==Eosinophilic colitis==
==Eosinophilic colitis==
Michael
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