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At least 1,279 records · Page 71Linked to original sources
PubMed2004

Diagnostic difficulties in pouchitis--experience from a single institution.

The aim of the study was to analyze the clinical, endoscopic and histological signs of pouchitis in patients operated on because of ulcerative colitis (UC) and familial adenomatous polyposis (FAP). Between 1984 and 2002, the Department of Surgery carried out 218 restorative proctocolectomies in patients with UC and 120 in FAP patients. The follow-up to assess the intensity of inflammatory changes included 110 patients: 72 UC and 38 FAP. During the endoscopic examination, samples were taken for routine histological examinations. The histological assessment was based on the so-called Moskwitz's Histological System. Acute pouchitis is diagnosed if the score is > or =4, and chronic condition--if the score is > or =4. We used a modified PDAI scale to analyze the symptoms, taking into account the microscopically detectable histological features of chronic pouchitis. The clinical symptoms of pouchitis were revealed in 28 patients (25.5%), endoscopic symptoms in 36 patients (32.7%), and histological parameters in 48 patients (28-58.3% with > or =4 score of acute pouchitis and 20-41.7% with > or =4 score of chronic pouchitis). The signs of acute and chronic pouchitis were evident in endoscopy and histology, with no clinical features observed in many cases. Patients with symptoms of chronic pouchitis require a continuous follow-up.

Adenomatous Polyposis Coli↗
PubMed2005

[Pathomorphology of ulcerative colitis].

Microscopic and macroscopic appearances of ulcerative colitis (UC) by its phase of inflammation were summarized. The most characteristic microscopic findings of active phase UC is diffuse lymphoplasmacytic infiltration, essentially associated with basal plasmacytosis. Although inflammation of UC is basically limited to the mucosa, active inflammation extends into the submucosa in some instance, and acute ischemic change is overlapped to cause toxic megacolon. In remission phase, inflammation is reduced and goblet cell mucus is fully recovered but evidences of the past inflammation such as irregular shape and disarrangement of crypts, Paneth cell metaplasia, thickening of the muscularis mucosae and discrepancy between the crypt base and the muscularis mucosae are usually demonstrated. Macroscopic appearances of UC reflect its microscopic findings such as degree of inflammation, whether inflammation is (was) limited to the mucosa or extend(ed) into the submucosa. Active phase is classified into erythematous, spongy, granular, pseudopolyp, ulcerative, and fulminant (toxic megacolon) type. In the former two types, inflammation is limited in the mucosa, and the latter two types are associated with ischemic change. In remission phase, erythematous and spongy types recover to the almost normal looking mucosa or fine granular mucosa with preservation of mucosal folds, granular type recovers to granular, fine granular or flat atrophic mucosa without preservation of mucosal folds, and pseudopolyp type recovers to mucosa with inflammatory polyposis.

Colitis, Ulcerative↗
PubMed1990

[Autoradiography of DNA synthesis in colonic mucosa of patients with familial adenomatosis coli].

In connection with routine endoscopic examinations of 31 patients with familial adenomatosis coli and 28 health kindreds of patients with familial adenomatosis coli we investigated by autoradiography the in vitro incorporation of 3H-thymidine into bioptic mucosal particles from colon and adenomas. Within the 5-year follow-up period there was found a significantly increased labelling index of polyps and the surrounding mucosa in patients with polyposis independing on the time elapsed after operation. In 12 of 28 kindreds the histological normal colonic mucosa showed an increased labelling index too. The prognostic value of these results must be proofed by further controls.

Adenoma↗
PubMed1989

Gastroduodenal polyps in familial polyposis coli.

This endoscopic evaluation of 25 patients with familial polyposis coli (FPC) further establishes gastro-duodenal polyps as a significant extracolonic manifestation of the condition. Ten patients had polyps, distributed as follows: stomach (2), duodenum (4), stomach and duodenum (4). Altogether, there were six gastric and seven duodenal lesions. Half of the gastric tumors were hyperplastic and half were adenomatous. All the duodenal tumors were adenomatous, four being ampullary. The one symptomatic patient had intra-polypoid adenocarcinoma. There were no significant correlations between the endoscopic findings and patient age, sex, presence of colon cancer, or other extracolonic abnormalities. The authors affirm that gastroduodenal polyps are an important component of FPC and recommend that all patients with this condition undergo initial and follow-up gastroduodenoscopy. Multiple small lesions may be carefully monitored, but larger ones, particularly those in the region of the ampulla, must be excised.

Adenomatous Polyposis Coli↗
PubMed1987

[Proposal for a radiological classification of multiple adenomatosis of the colon].

The double contrast enemas of 47 patients with multiple adenomatosis of the colon and rectum were analyzed. According to the density and the distribution of polyps on the mucosal surface, the radiological patterns were classified into three different groups: sporadic, dense and confluent adenomas. Radiographic patterns of each patient were related to the clinical and pathological data collected during the diagnosis and the follow-up. The clinical and pathological features and the evolution of the disease appear to be different in each group of patients (identified by the radiological classification). The occurrence of cancer at the time of the diagnosis of polyposis is closely correlated either to the number of polyps or to their size and the age of patients. The occurrence of metachronous cancer is correlated only to the number of polyps, not to their size, nor to the surgical treatment of the polyposis. If these data are confirmed on a wider number of patients, the role of radiological survey might become a more prominent one, not only in diagnosing, but also in therapy planning, as well as in the prognostic evaluation of multiple adenomatosis of colon.

Adenoma↗
PubMed1988

The adenomatous polyp and the hereditary polyposis syndromes.

Adenomatous polyps are the benign precursors of colorectal adenocarcinoma. Colonic adenomas occur commonly in adults in Western countries. There is recent evidence that inheritance may play an important role in the etiology of these adenomatous polyps. Colonic adenomatous polyposis (numerous colonic adenomas) is the central feature of several rare inherited syndromes that give rise to colorectal cancer. There also appears to be a risk of gastrointestinal and other malignancies in the rare inherited syndromes of hamartomatous polyposis.

Adenomatous Polyposis Coli↗