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. 2014 Mar;30(2):373-9.
doi: 10.12669/pjms.302.5050.

Spectrum of pathologies in cases of intestinal obstruction & perforation based on histopathological examination of resected intestine - Report from a third world country

Noshin Wasim Yusuf  1 , Sehr Iqbal  2 , Rahat Sarfraz  3 , Shezada Khalid Sohail  4 , Mohammad Imran  5
Affiliations

Spectrum of pathologies in cases of intestinal obstruction & perforation based on histopathological examination of resected intestine - Report from a third world country

Noshin Wasim Yusuf et al. Pak J Med Sci. 2014 Mar.

Abstract

Background and objective: Cases presenting with intestinal perforation and obstruction constitute a substantial work load on our surgical service. Etiologies vary in underdeveloped and developed countries. Histopathological examination of resected intestine is expected to provide the definite evidence of the underlying etiology- guiding a better health care planning for preventive measures. Our objective was to study the spectrum of histopathological findings in resected intestines from cases of intestinal obstruction and perforation in our local population to document the underlying etiology.

Methods: A total of 120 cases of intestinal resection were included. Detailed gross and microscopic examination with routine stains was performed. Definite evidence of any specific etiology on the basis of morphology was documented.

Results: A total of 95 cases with clinical/radiological diagnosis of obstruction (79.2%) and 25 of intestinal, perforation (20.8%) were included. Tuberculous enteritis was the commonest etiology (n=41; 43.1%) in cases of intestinal obstruction followed by malignant tumours (n=30; 31.5%). ischemic infarct/gangrene, post op illeal adhesions, polyps and ulcerative colitis followed. In cases of perforation, Typhoid enteritis (n=15; 60%), was the commonest pathology followed by idiopathic perforation (n=5; 20%), tuberculous enteritis (n=3;12%), carcinoma (4%) and ulcerative coliti (4%). Conclusion : In developing countries infective etiology remains a dominant cause of intestinal obstruction and perforation. Its presentation in younger age leading to intestinal resection demands effective preventive measures in this part of the world to prevent morbidity and mortality.

Keywords: Intestinal resection; Perforation; Polyps; Tuberculous enteritis.

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Figures

Fig.1
Fig.1
Gross photograph of an intestinal resection specimen showing a transverse mucosal stricture
Fig.2
Fig.2
Gross photograph of an intestinal resection specimen, showing ileoileal intussusceptions with mucosal polyps (leading factor).
Fig.3
Fig.3
Gross photograph of intestinal resection specimen, showing multiple pseudopolyps carpeting the whole mucosa of a case of Ulcerative Colitis
Fig.4
Fig.4
Photomicrograph of caseating granulomatous enteritis Haemotoxylin / Eosin stain (10x).
See this image and copyright information in PMC

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