Diversion colitis: histological features in the colon and rectum after defunctioning colostomy

Article Abstract:

Under ordinary circumstances, ingested food passes through the stomach, small and large intestine, and is excreted as fecal material. In the treatment of some disease states, the intestine can be externalized through the abdominal wall (ileostomy, colostomy), with the consequence that the fecal stream exits through the ostomy opening, and does not pass through the sections of intestine distal to (below) that point. In some cases, an inflammatory condition known as diversion colitis may develop in the 'defunctioned' portion of the intestine. This may be confused with inflammatory bowel disease (IBD), a condition with somewhat similar symptoms. Treatment for the two conditions is exactly opposite; IBD should be treated by reducing the passage of intestinal contents through the afflicted segment, whereas diversion colitis is best treated by reattaching the bypassed segment of intestine (reanastomosis). Studies of biopsy material from patients with diversion colitis have not revealed any consistent pattern of microscopic alteration that might be used to distinguish these patients from those with IBD. To further characterize the microscopic anatomy of intestine from patients with diversion colitis, a study was carried out in which small sections of intestine were sugically removed from 15 patients without pre-existing IBD. Nine of the patients developed diversion colitis between 9 months and 17 years after the diversion procedure (all prior to initiation of the current study). Fourteen of the patients had microscopic abnormalities of the resected segment, with no apparent basis for distinguishing patients with diversion colitis from those without it. Hence, microscopic analysis of intestinal tissue from patients with diversion colitis is unlikely to provide a definitive diagnosis, but might help avoid a mistaken diagnosis of IBD. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Colorectal diseases, Intestinal diseases, Colitis, Colostomy

---

Malignant colorectal polyps: venous invasion and successful treatment by endoscopic polypectomy

Article Abstract:

Adenocarcinoma of the colon and rectum is a form of cancer that usually progresses from a pre-existing adenoma to a malignant, metastatic condition of uncontrolled growth. The lesion continues to assume the appearance of a polyp until a very advanced stage, when it becomes ulcerated. Removal of the malignant polyp (polypectomy) is quite successful as a curative therapy for early stages of this condition, with success rates reported between 85 and 100 percent. It has been suggested that invasion of the polyp by vasculature or the lymph system is associated with a poor prognosis, but this is controversial. To further investigate the relationship between the microscopic structure of malignant polyps and the likelihood of residual metastasis, the cases of 80 patients treated for one or more malignant polyp were reviewed. In most cases (73), polyps were removed by endoscopic snare polypectomy, a procedure in which a flexible fiber-optic viewing device is introduced into the rectum or colon, and the polyp encircled with a ligature that is used to tie off the polyp, allowing its removal. In seven cases, a slightly different non-invasive method was used; in one case, a segment of the colon was surgically removed. All patients were available for at least five-year follow-up. Of the patients treated by polypectomy, four (5.6 percent) died within five years of cancer; one (1.4 percent) of recurrent tumor. Venous invasion of the tumor was common, but had no predictive significance for recovery or relapse. In cases where the tumor was well differentiated and excision complete, the prognosis for complete recovery following polypectomy was excellent. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Care and treatment, Colorectal cancer, Prognosis, Surgery, Adenocarcinoma, Colon (Anatomy), Rectum, Colon surgery, Polypectomy

---

Upper gastrointestinal pathology in familial adenomatous polyposis: results from a prospective study of 102 patients

Article Abstract:

Familial adenomatous polyposis (FAP), first described in 1895, is an inherited, autosomal dominant condition. It is characterized by multiple and potentially malignant adenomas (tumors) throughout the colon and rectum. The pathological descriptions and locations of gastrointestinal (GI) lesions vary widely. This study examined 102 patients from 69 families. The pathologies detected in patients with FAP in a prospective screening program are discussed. None of the patients had any gastrointestinal (GI) complaints. They were all examined endoscopically, and the site, number and size of polyps noted and recorded on map of the periampullary region. Biopsies of representative gastric and duodenal polyps were taken. In the absence of polyps, antral and duodenal specimens were taken. Adenomas were noted in the duodenum of 94 patients. Fundic gland polyps were the most commonly found abnormality in the stomach, seen microscopically in 44 patients. Various types of hyperplasia (overgrowth of tissue) were found in patients with adenomas. The percentage of adenomas in this study, 92 percent, was greater than that cited in many previous reports. There is an increasing body of evidence to suggest that a strong relationship exists between adenomas and carcinoma (cancer), with and without polyposis, in the upper GI tract as well as the lower portion of the system. The severity of polyposis has been graded O to IV, based on quantity, size, histology and degree of dysplasia. Those with grade IV are at greatest risk of malignant change and should be closely observed and followed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Development and progression, Intestinal polyps, Polyposis, Familial, Familial polyposis, Gastrointestinal cancer, Digestive system cancer

Similar abstracts:

• Abstracts: Caffeine, moderate alcohol intake, and risk of fractures of the hip and forearm in middle-aged women. Dietary predictors of symptom-associated gallstones in middle-aged women
• Abstracts: Selective termination: clinical experience and residual risks. Age-specific variation in aneuploidy incidence among biochemical screening programs
• Abstracts: Gastroduodenal mucosa in uraemia: endoscopic and histological correlation and prevalence of helicobacter-like organisms
• Abstracts: Caffeine, moderate alcohol intake, and risk of fractures of the hip and forearm in middle-aged women. part 2 A prospective study of the intake of vitamins C, E, and A and the risk of breast cancer
• Abstracts: The relationship between maternal hematocrit and pregnancy outcome. Health behavior and outcomes in sequential pregnancies of black and white adolescents

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.