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Diversion colitis histopathologic features

Annabel Kleinwort, Paula Döring, Christine Hackbarth, Claus-Dieter Heidecke, Tobias Schulze
INTRODUCTION: Diversion colitis is a significant health problem due to its high incidence in patients with diverting enterostomy. This mucosal inflammation presents characteristic histopathological features allowing for the differentiation of this entity from other inflammatory bowel diseases. The pathophysiology of this disease remains ill-defined, in part due to the lack of appropriate animal models. The present study was performed in order to develop and characterize a murine model of diversion colitis...
2017: BioMed Research International
Wouter B van der Sluis, Eskelina A Neefjes-Borst, Mark-Bram Bouman, Wilhelmus J H J Meijerink, Nanne K H De Boer, Margriet G Mullender, Adriaan A van Bodegraven
AIMS: Autologous intestinal grafts are used to (re)create a vagina in selected patients. The risk of diversion colitis is mentioned as a disadvantage, although its prevalence remains unclear. This study aimed to assess the histopathological characteristics of the sigmoid-derived neovaginal epithelial lining after diverting surgery and correlate these with clinical findings. METHODS AND RESULTS: Biopsy specimens were obtained from the epithelial lining of the sigmoid-derived neovagina and remaining rectosigmoid as regular follow-up from 26 patients with a median age of 22 years (range 19-52) and median postoperative follow-up of 13 months (range 6-52)...
June 2016: Histopathology
Gian Eugenio Tontini, Maurizio Vecchi, Luca Pastorelli, Markus F Neurath, Helmut Neumann
Distinction between Crohn's disease of the colon-rectum and ulcerative colitis or inflammatory bowel disease (IBD) type unclassified can be of pivotal importance for a tailored clinical management, as each entity often involves specific therapeutic strategies and prognosis. Nonetheless, no gold standard is available and the uncertainty of diagnosis may frequently lead to misclassification or repeated examinations. Hence, we have performed a literature search to address the problem of differential diagnosis in IBD colitis, revised current and emerging diagnostic tools and refined disease classification strategies...
January 7, 2015: World Journal of Gastroenterology: WJG
Roger M Feakins
Accurate histopathological assessment of biopsies is important for the diagnosis, subclassification, and management of chronic idiopathic inflammatory bowel disease (IBD). British Society of Gastroenterology (BSG) guidelines for the initial histopathological diagnosis of IBD were published in 1997. Changes since then include: more widespread use of full colonoscopy; greater recognition of the effects of time and treatment; improved documentation of variations in anatomical distribution; better understanding of the mimics of IBD; significant progress in clinical management; and modifications of terminology...
December 2013: Journal of Clinical Pathology
Lisa A Cerilli, Joel K Greenson
CONTEXT: A variety of inflammatory disorders may affect the colon, with widely differing clinical outcomes and management. These conditions encompass a spectrum of acute and chronic conditions. OBJECTIVE: Review the pathology of the major colitides and highlight the most diagnostically useful features. DATA SOURCES: Review of recent literature supplemented with personal experience in the field of gastrointestinal pathology. CONCLUSIONS: The etiologies associated with the various types of colitis are diverse and the range of histologic changes is somewhat limited...
August 2012: Archives of Pathology & Laboratory Medicine
Johanna D Strehl, Arndt Hartmann, Abbas Agaimy
BACKGROUND: IgG4-related systemic fibrosclerosis is a recently defined disorder characterised by a diffuse or tumefactive inflammatory reaction rich in IgG4-positive plasma cells associated with sclerosis and obliterative phlebitis. Although characteristic histopathological features are essential for the diagnosis of these disorders, to date there exists no consensus regarding the cut-off values used to define a 'significant IgG4-positive plasma cell count,' and data regarding the distribution of IgG4-positive plasma cells under common (non-specific) inflammatory conditions are lacking...
March 2011: Journal of Clinical Pathology
You-you Luo, Jie Chen
OBJECTIVE: To analyze clinical manifestations, endoscopic and histological features for establishing a diagnosis of pediatric inflammatory bowel disease (IBD). METHOD: Thirty-four inpatients with inflammatory bowel disease (ulcerative colitis/UC/: 24; Crohn's disease/CD/:10) were enrolled into this study. Data of clinical manifestations, laboratory values, endoscopic findings and histopathological features of biopsy material were analyzed. RESULT: Four children had mild/moderate active Crohn's disease...
February 2009: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Hugh J Freeman
Collagenous mucosal inflammatory diseases involve the columnar-lined gastric and intestinal mucosa and have become recognized increasingly as a significant cause of symptomatic morbidity, particularly in middle-aged and elderly women, especially with watery diarrhea. Still, mechanisms involved in the pathogenesis of this diarrhea remain poorly understood and require further elucidation. The prognosis and long-term outcome of these disorders has been documented only to a limited extent. Recent clinical and pathologic studies have indicated that collagenous mucosal inflammatory disease is a more extensive pathologic process that concomitantly may involve several sites in the gastric and intestinal mucosa...
July 2005: Gastroenterology
Peter Ngo, Glenn Furuta, Wesley Burks
Over the past decade clinicians have witnessed a dramatic rise in the prevalence of eosinophilic gastrointestinal diseases. Diverse symptoms, a broad range of endoscopic findings, and varying histopathologic features pose several questions: Do eosinophils represent an allergic response? What mechanisms drive eosinophils to specific mucosal targets? How do eosinophils affect the gastrointestinal tissues? Recent clinical and basic studies are investigating the pathogenesis of eosinophilic gastrointestinal diseases...
December 2004: Current Gastroenterology Reports
E M Kiely, N A Ajayi, R A Wheeler, M Malone
BACKGROUND/PURPOSE: Diversion procto-colitis (DPC) results from a deficiency of luminal short-chain fatty acids (SCFAs). Endoscopic and histopathologic features of the disorder are almost universally present in defunctioned bowel, but symptomatic DPC is less common. METHODS: Five children with symptomatic DPC underwent endoscopy and rectosigmoid biopsies. An endoscopic index (EI) was used to quantify disease severity. An SCFA mixture was administered into the defunctioned bowel...
October 2001: Journal of Pediatric Surgery
M Micev
Distinguishing of indeterminate colitis from ulcerative colitis or Crohn's disease in more than 10% of IBD cases as separate diagnostic category (IIBD) is defined by: first, overlapping or paucity of features of two major IBD forms in acute fulminant colitides and few chronic slowly progressive cases without differentiating markers of chronicity, and second, inability to reach specific diagnosis during or after completed clinical, radiological, endoscopical and histopathological examination of chronic colitis with inconclusive presentation of IBD-compatible cases...
2000: Acta Chirurgica Iugoslavica
F M Giardiello, A J Lazenby
Collangenous colitis is a clinicopathologic syndrome characterized by (1) chronic watery diarrhea and crampy abdominal pain and (2) distinctive colorectal histopathology that includes a subepithelial collagen band, prominent chronic inflammation in the lamina propria, and increased intraepithelial lymphocytes. Lymphocytic colitis has similar clinical features to collangenous colitis, the main symptom being chronic watery diarrhea. Diversion colitis is an inflammatory process that arises in segments of the large intestine that are excluded from the fecal stream...
June 1999: Gastroenterology Clinics of North America
C M Edwards, B George, B Warren
Diversion proctocolitis is an iatrogenic disorder caused by surgical diversion of the faecal stream away from the colorectal mucosa. Such surgery may be necessary in cases of tumour, trauma or inflammatory conditions of the colorectum. Histopathological change is characterized by a chronic lymphoplasmacytic inflammatory infiltrate, and the hallmark feature, lymphoid follicular hyperplasia. Histological appearances are determined by the disease state of the colonic mucosa prior to faecal diversion. Macroscopic appearances may vary considerably, but often include aphthoid ulceration...
January 1999: Histopathology
S Haque, R N Eisen, A B West
Studies of diversion colitis have not shown a consistent pattern of histopathologic features, and many descriptions are difficult to interpret because of the presence of underlying intestinal mucosal disease. To define the histologic changes in patients free of other mucosal inflammatory disease, we studied the resected segments of bypassed colorectum from 37 patients with Hirschsprung's disease treated by a two-stage procedure, using rectal biopsy specimens taken for initial diagnosis and trimmings from proximal to the stoma as controls...
February 1993: Human Pathology
J H Yoon, J G Ryu, J K Lee, S J Yoon, H C Jung, I S Song, K W Choi, C Y Kim
Amebic colitis is a disease revealing diverse clinical manifestations and endoscopic gross features and often confused with other types of colitis. In case of misdiagnosis as an idiopathic inflammatory bowel disease or delayed recognition of intestinal amebiasis, an undesirable outcome may occur resulting from erroneous administration of steroids or delayed antiamebic treatment. To demonstrate the pitfalls in the diagnosis and treatment of intestinal amebiasis, 3 cases of amebic colitis with atypical clinical manifestations are presented in this paper...
September 1991: Journal of Korean Medical Science
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