Studies in Ulcerative Colitis: TPN-Linked Dehydrogenases and Nonspecific Esterase in Rectal Biopsy Specimens

Background. Ulcerative colitis is a chronic inflammatory disease of unknown origin, characterized by a clinically recurrent course with periods of bloody diarrhea and pathomorphological-diffuse inflammatory process in the colon. The problem of ulcerative colitis requires further study of the clinical features of the disease, taking into account the localization, degree of activity of the inflammatory process, changes in the structure of the mucous membrane that will help increase the efficiency of ulcerative colitis diagnosis in childhood. Materials and methods. On the basis of clinical and statistical analysis of 116 case histories of children aged 4–18 years with ulcerative colitis, the features of its clinical forms — total, segmental and distal — were studied during the period of exacerbation of the disease. Four hundred and forty-five biopsy specimens obtained during colonoscopy were histologically examined. After biopsy sampling, specimens were fixed in 10% formalin and were processed according to the generally accepted histological method with section staining using hematoxylin-eosin and according to Van Gieson. Results. Changes in the architectonics of the large intestine mucosa, which reduce the resistance of the mucous barrier, as well as impaired blood supply — a factor in the development of hemic hypoxia — are significant for the mechanisms of ulcerative colitis exacerbation.

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Clinical Implications of Histologic Abnormalities in Colonic Biopsy Specimens from Patients with Ulcerative Colitis in Clinical Remission

Inflammatory Bowel Diseases ◽

10.1097/mib.0b013e318281f4ae ◽

2013 ◽

Vol 19 (7) ◽

pp. 1477-1482 ◽

Cited By ~ 20

Author(s):

Linda A. Feagins ◽

Shelby D. Melton ◽

Ramiz Iqbal ◽

Kerry B. Dunbar ◽

Stuart J. Spechler

Keyword(s):

Ulcerative Colitis ◽

Clinical Remission ◽

Clinical Implications ◽

Biopsy Specimens ◽

Colonic Biopsy

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Total Colonic Aganglionosis: Case Report, Practical Diagnostic Approach and Pitfalls

Archives of Pathology & Laboratory Medicine ◽

10.5858/2010-0279-cr.1 ◽

2010 ◽

Vol 134 (10) ◽

pp. 1467-1473 ◽

Cited By ~ 3

Author(s):

Raja Rabah

Keyword(s):

Transition Zone ◽

Ganglion Cells ◽

Hirschsprung Disease ◽

Rectal Biopsy ◽

Nerve Fibers ◽

Submucosal Plexus ◽

Total Colonic Aganglionosis ◽

Biopsy Specimens ◽

Suction Rectal Biopsy ◽

Acetylcholinesterase Staining

Abstract Hirschsprung disease remains a challenging diagnosis for many pathologists. The disease is characterized by a lack of ganglion cells in the myenteric and submucosal plexus, associated with increased numbers of acetylcholinesterase-positive nerve fibers. Hypertrophic nerve fibers are present in most but not all patients. Total colonic aganglionosis (TCA) is an uncommon form of Hirschsprung disease with clinical, histologic, and genetic differences and is even more difficult to diagnose and manage. This case illustrates some of the difficulties frequently faced by the pathologists dealing with total colonic aganglionosis. Suction rectal biopsy specimens often lack significant nerve hypertrophy and positive acetylcholinesterase staining, which aid in the diagnosis. Pathologists have to depend mainly on the lack of ganglion cells in adequate submucosa to establish the diagnosis. Transition zone is often long in total colonic aganglionosis and interpretation of frozen sections can be difficult. The presence of several uniformly distributed clusters of mature ganglion cells and lack of nerve hypertrophy are required to avoid connections at the transition zone.

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Megacystis-Microcolon-Intestinal Hypoperistalsis Syndrome

PEDIATRICS ◽

10.1542/peds.63.5.805 ◽

1979 ◽

Vol 63 (5) ◽

pp. 805-808

Author(s):

Thomas E. Wiswell ◽

James S. Rawlings ◽

James L. Wilson ◽

Gary Pettett

Keyword(s):

Neonatal Period ◽

Ganglion Cells ◽

Plain Film ◽

Rectal Biopsy ◽

Exploratory Laparotomy ◽

Nerve Fibers ◽

Bladder Obstruction ◽

Distended Abdomen ◽

Biopsy Specimens ◽

Hypoperistalsis Syndrome

The syndrome of megacystis-microcolon-intestinal hypoperistalsis has been reported in a total of seven female infants. Massive abdominal distention secondary to a distended urinary Fig 1. Plain film of markedly distended abdomen with no air beyond stomach. Stomach is displaced upward toward left. der was the major presenting characteristic. Iutestinal hypoperistalsis, apparent in the early neonatal period, persists without improvement. Exploratory laparotomy reveals malrotation and malfixation of a small microcolon. No anatomic cause of intestinal or bladder obstruction can be found. Intestinal and/or rectal biopsy specimens contain abundant ganglion cells and nerve fibers. The outcome has been uniformly fatal, with survival in the reported cases ranging from two days to 34 months.

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