Abstract
BACKGROUND:
Inflammatory bowel disease is group of inflammatory disorders of unknown etiology. The main members of this group are ulcerative colitis and Crohn's disease (granulomatous colitis).Histopathologic evaluation of colonoscopic mucosal biopsy remains one of the earliest modalities of investigation in patients which clinically suspected. Any biopsy underwent histopathological diagnosis should be accompanied by endoscopic findings and full clinical history.
OBJECTIVE :
Assessment of colonic biopsies in patients of colitis on the basis of specific histopathological criteria and correlation with clinical and endoscopic presentations.
METHOD :
A Retrospective and prospective study included randomly selected 102 colonic specimens from
January 2016 to June 2018.The clinicopathological parameters including (age of the patients, gender, hematochiza, diarrhea and abdominal pain) obtained from endoscopic reports and correlated with the histopathological parameters and sections which revised by a senior pathologist.
RESULTS:
Out of (102) patients in this study; there were 41(40.2%) males and 61(59.8%) females. hematochiza is the main presentation in ulcerative colitis, while abdominal pain is the main presentation in Crohn's disease patients and diarrhea in those with non-specific colitis. Certain parameters can favoring the diagnosis of non-specific colitis over inflammatory bowel disease and another set favoring ulcerative colitis over Crohn's disease and vice-versa. This leads in shifting of diagnosis of most of endoscopic biopsies rather than resection biopsies. And there is under diagnosis of cases of non-specific colitis and Crohns disease in comparism to Ulcerative colitis.
CONCLUSION:
Inflammatory bowel diseases are female predominate.Ulcerative Colitis predominate in 3rd and 4th decades of life, Crohn's disease is more in 2nd and 3rd decades while non specific colitis are more
found in old age. Correlation between clinical, endoscopic and histopathological features is essential in the diagnosis of inflammatory bowel diseases. Accurate diagnosis of inflammatory bowel diseases depends on finding of certain histopathological features.
10. Kumar NB, Nostrant TT, Appleman HD. The histopathological spectrum of acute self - limited colitis (acute infectious – type colitis). The American Journal of surgical pathology 1982 ; 6: 523-29.
11. Rubin 's E , Mitros FA. The gastrointestinal tracts. Essentials of Rubin's pathology 5th edition 2008;13:297-301.
12. Bernstein CN, Kraut A, Blachard JF et al. The relationship between inflammatory bowel disease and socioeconomic variable .AmJ. Gastroenterology 2001;96:2117-25.
13. Poller DN, Armitage NC. Mural brighing lesions in colonic Crohn's disease . Arch. pathology .LabMed.1993;117:550-552.
14. Sawczenko A, Sandhu BK. Presenting features of inflammatory bowel disease in great Britain andIrland.Arch .Dis. Child 2003; 88: 995-1000.
15. Geboes K. Histopatholgy of Crohn's disease and ulcerative colitis.IBD4e 2003; 18:255-76.
16. Beffe NL, Heresbach D, Kerbaol M et al. Histological discrimination of idiopathic inflammatory bowel disease from other types of colitis. J ClinPathol 1995;48:749–53.
17. Tanka M, Riddell RH, Saito H et al. Morphological criteria applicable to biopsy specimens for effective distinction of inflammatory bowel disease from other forms of colitis and of Crohn's diseasefrom ulcerative colitis. Scand Journal of Gastroenterology 1999; 56-66.
18. Surawicz CM, Haggitt RC, Husseman M et al. Mucosal biopsy diagnosis of colitis: acute self-limited colitis and idiopathic inflammatory bowel disease. Gastroenterology 1994;107:755–66.
19. Schmitz-Moormann P, Himmelmann GW. Does quantitative histology of rectal biopsy improve the differential diagnosis of Crohn’s disease and ulcerative colitis in adult? Pathol Res Pract : –8.
20. Cook MG, Dixon NW. An analysis of the reliability of detection and diagnostic value of various pathological features in Crohn’s disease and ulcerative colitis Gut ; : –62.
21. Monsen U. Inflammatory bowel disease. An epidemiological and genetic study. Acta Chir Scand Supp1990;559:1-42.
22. Van Gossum A , Alder M , De Reuck M et al . Epidemiology of inflammatory bowel disease in Brussels'area (1992-1993). Acta Gastroenterology Belg 1996; 59: 7-9.
23. Tazun N , Atug O, Imeryuz N et al .Clinical characteristics of inflammatory bowel disease in Turkey:a multicenter epidemiologic survey . J Clin Gastroenterology 2009; 43: 51-7.
24. Buenavida G.,Casanias A, Vasquenz C et al . incidence of inflammatory bowel disease in five Geographic areas of Uruguay in the biennial 2007-2008. Acta Gastroenterology Latinoam2011; 41(4):281-7.
25. Al Saleem K, El Mouzan MI, Saadah OI et al. Characteristic of pediatric ulcerative colitis in SaudiArabia:a multicenter national study. Ann Saudi Med2015; 53;19-22.
26. Isa HM, Mohamed AM, Al-Jawder HE et al. Pediatric Crohn's disease in Bahrain .Oman Med J 2018;33:299-308.
27. Fumery M, Kohut M, Gower-Roysseau C et al. Incidence , clinical presentation , and associated factors of microscopic colitis in Northern France : Apopulation – Based study. Dig.Dis.Sci2017; 62:1571-79.
28. Aghazadeh R, Zali MR ,Bahari A et al. Inflammatory bowel disease in Iran :a review of 457 cases.J Gastroenterology hepatology 2005;20:1691-5.
29. Penn KA, Whittle DO, Lee MG. Inflammatory bowel disease in Jamaica. Ann Gastroenterology 2013;26:239-42.
30. Sathiyasekaran M, Bavanandam S, Sankarayarayanan S et al. A Questionnaire survey of pediatric
inflammatory bowel disease in India . Indian J Gastroenterrology 2014;33 :543-9.
31. Assadangabi A, Lobo AJ. Diagnosing and Managing inflammatory bowel disease. Practitioner 2013;257:13-8.
32. Aziz DA, Moin M, Majeed A et al .Pediatric inflammatory bowel disease : clinical presentation and disease location . Pak J Med2017 ;33: 793-97.
33. Wang YF, Zhang H ,Ouyang Q. Clinical manifestation of inflammatory bowel disease . J Dig. Dis2007;8:121-7.
34. Pillai RB, Tolia V. Colonic polyps in children : frequently multiple and recurrent . Clin. Pediatra (phila)1998;37:243-7.
35. Al Ashgar H, Peedikayil M, Chaudhri N et al . Defection of a " colon cast " as a rare presentation ofacute Graft – Versus – host disease .Ann Saudi Med 2009; 29 :231-3.
)
