Abstract
Mucosal biopsy specimens from the ileal reservoirs of 92 patients who had undergone restorative proctocolectomy (12 with familial adenomatous polyposis, 78 with ulcerative colitis, and two with functional bowel disease) were studied. Chronic inflammation was found in almost all, as was villous atrophy of varying severity. Other changes included pyloric metaplasia and mucosal prolapse. Acute inflammatory changes and ulceration were less common but, when present, corresponded to the clinical condition of "pouchitis". A grading system was devised to score acute and chronic inflammatory changes. There was a significant increase in acute inflammatory scores in ulcerative colitis compared with those in familial adenomatous polyposis, and pouchitis was present only in patients who had had ulcerative colitis; the morphological features of pouchitis are similar to those seen in the colorectal mucosa in ulcerative colitis. Histochemical studies of mucin in the reservoirs of mucosa showed that there may have been a change from small intestinal mucin to colonic mucin.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Beart R. W., Jr, Fleming C. R., Banks P. M. Tubulovillous adenomas in a continent ileostomy after proctocolectomy for familial polyposis. Dig Dis Sci. 1982 Jun;27(6):553–556. doi: 10.1007/BF01296737. [DOI] [PubMed] [Google Scholar]
- Filipe M. I. Mucins in the human gastrointestinal epithelium: a review. Invest Cell Pathol. 1979 Jul-Sep;2(3):195–216. [PubMed] [Google Scholar]
- Gerard A., Berrod J. L., Loygue J. EORTC trials in large bowel cancer. Int J Colorectal Dis. 1986 Apr;1(2):116–120. doi: 10.1007/BF01648419. [DOI] [PubMed] [Google Scholar]
- Hamilton S. R., Bussey H. J., Mendelsohn G., Diamond M. P., Pavlides G., Hutcheon D., Harbison M., Shermeta D., Morson B. C., Yardley J. H. Ileal adenomas after colectomy in nine patients with adenomatous polyposis coli/Gardner's syndrome. Gastroenterology. 1979 Dec;77(6):1252–1257. [PubMed] [Google Scholar]
- Hultén L., Svaninger G. Facts about the Kock continent ileostomy. Dis Colon Rectum. 1984 Aug;27(8):553–557. doi: 10.1007/BF02555527. [DOI] [PubMed] [Google Scholar]
- Jass J. R., England J., Miller K. Value of mucin histochemistry in follow up surveillance of patients with long standing ulcerative colitis. J Clin Pathol. 1986 Apr;39(4):393–398. doi: 10.1136/jcp.39.4.393. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Madigan M. R., Morson B. C. Solitary ulcer of the rectum. Gut. 1969 Nov;10(11):871–881. doi: 10.1136/gut.10.11.871. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Moskowitz R. L., Shepherd N. A., Nicholls R. J. An assessment of inflammation in the reservoir after restorative proctocolectomy with ileoanal ileal reservoir. Int J Colorectal Dis. 1986 Jul;1(3):167–174. doi: 10.1007/BF01648445. [DOI] [PubMed] [Google Scholar]
- Nicholls R. J., Belliveau P., Neill M., Wilks M., Tabaqchali S. Restorative proctocolectomy with ileal reservoir: a pathophysiological assessment. Gut. 1981 Jun;22(6):462–468. doi: 10.1136/gut.22.6.462. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nicholls R. J., Pezim M. E. Restorative proctocolectomy with ileal reservoir for ulcerative colitis and familial adenomatous polyposis: a comparison of three reservoir designs. Br J Surg. 1985 Jun;72(6):470–474. doi: 10.1002/bjs.1800720622. [DOI] [PubMed] [Google Scholar]
- Parks A. G., Nicholls R. J. Proctocolectomy without ileostomy for ulcerative colitis. Br Med J. 1978 Jul 8;2(6130):85–88. doi: 10.1136/bmj.2.6130.85. [DOI] [PMC free article] [PubMed] [Google Scholar]
- SPICER S. S. The use of various cationic reagents in histochemical differentiation of mucopolysaccharides. Am J Clin Pathol. 1961 Nov;36:393–407. doi: 10.1093/ajcp/36.5.393. [DOI] [PubMed] [Google Scholar]
- Utsunomiya J., Iwama T., Imajo M., Matsuo S., Sawai S., Yaegashi K., Hirayama R. Total colectomy, mucosal proctectomy, and ileoanal anastomosis. Dis Colon Rectum. 1980 Oct;23(7):459–466. doi: 10.1007/BF02987076. [DOI] [PubMed] [Google Scholar]