Difference between revisions of "Colon"

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Colon (view source)

Revision as of 12:21, 16 January 2014

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→‎Eosinophilic colitis: split out
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==Eosinophilic colitis==
==Eosinophilic colitis==
===General===
*Abbreviated ''EC''.
*Rare.
{{Main|Eosinophilic colitis}}
*May be a component of ''[[eosinophilic gastroenteritis]]''.<ref name=pmid22012125/>
 
Clinical features:<ref name=pmid22012125/>
*Abdominal pain
*Diarrhea +/-blood.
*+/-Weight loss.
 
===Gross===
Features - endoscopic:<ref name=pmid22012125>{{Cite journal  | last1 = Alfadda | first1 = AA. | last2 = Storr | first2 = MA. | last3 = Shaffer | first3 = EA. | title = Eosinophilic colitis: an update on pathophysiology and treatment. | journal = Br Med Bull | volume = 100 | issue =  | pages = 59-72 | month =  | year = 2011 | doi = 10.1093/bmb/ldr045 | PMID = 22012125 | PMC = 3165205 }}</ref>
*Edema.
*Granular appearance.
 
===Microscopic===
Features:<ref name=pmid22012125/>
*Abundant eosinophils - no agreed upon number.
**"Most use 20/[[HPF]]" <ref name=pmid19554649>{{Cite journal  | last1 = Okpara | first1 = N. | last2 = Aswad | first2 = B. | last3 = Baffy | first3 = G. | title = Eosinophilic colitis. | journal = World J Gastroenterol | volume = 15 | issue = 24 | pages = 2975-9 |  month = Jun | year = 2009 | doi =  | PMID = 19554649 | PMC = 2702104 }}</ref> - a definition that suffers from [[HPFitis]].
***There is variation along the large bowel - normal in rectum <10/HPF, normal in cecum <30/HPF (???).<ref name=pmid19554649/>
 
DDx:<ref name=pmid22012125/>
*[[Inflammatory bowel disease]]:
**[[Crohn's disease]].
**[[Ulcerative colitis]].
*Infection:
**[[Pinworm]].
**[[Strongyloidiasis]].
*Autoimmune disease:
**[[Scleroderma]].
**[[Churg-Strauss syndrome]].
**[[Celiac disease]].
*[[Drug reaction]]s.
 
Image:
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2702104/figure/F1/ EC (nih.gov)].<ref name=pmid19554649>{{Cite journal  | last1 = Okpara | first1 = N. | last2 = Aswad | first2 = B. | last3 = Baffy | first3 = G. | title = Eosinophilic colitis. | journal = World J Gastroenterol | volume = 15 | issue = 24 | pages = 2975-9 | month = Jun | year = 2009 | doi =  | PMID = 19554649 | PMC = 2702104 }}</ref>
 
===Sign out===
<pre>
DESCENDING COLON, BIOPSY:
- COLONIC MUCOSA WITH MILD EOSINOPHILIA, SEE COMMENT.
- NEGATIVE FOR DYSPLASIA.
 
COMMENT:
Focally, there are up to 40 eosinophils / 0.2376 mm*mm (approx. field area at 400X). This
is a non-specific finding. No eosinophilic crypt abscesses are seen. No (neutrophilic)
cryptitis is present. Clinical correlation is suggested.
</pre>
 
<pre>
DESCENDING COLON, BIOPSY:
- COLONIC MUCOSA WITH MILD EOSINOPHILIA, SEE COMMENT.
- NEGATIVE FOR ACTIVE COLITIS.
- NEGATIVE FOR DYSPLASIA.
 
COMMENT:
There are up to 40 eosinophils / 0.2376 mm*mm (field area at 400X). This is a
non-specific finding.  The differential diagnosis includes inflammatory bowel
disease, infection (especially helminths), a drug reaction, and autoimmune
disorders (e.g. Churg-Strauss syndrome, celiac disease, scleroderma). Clinical
correlation is required.
</pre>


=Infectious=
=Infectious=
Michael
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