Frozen section of the gastrointestinal tract, appendix, and peritoneum

Intraoperative consultation is frequently requested by surgeons operating on the gastrointestinal tract, appendix, and peritoneum. In this setting, the pathologist's diagnosis plays a central role in determining whether a resection is needed, and if so, how much to resect and whether it was adequate. There is no room for errors in the frozen section laboratory, because a small mistake can have serious consequences. To my knowledge, no recent books or publications in the literature have dealt with this important topic.

To review the intraoperative consultation of the gastrointestinal tract, appendix, and peritoneum.

The MEDLINE database was queried for keywords, including gastrointestinal, esophagus, stomach, esophageal, gastric, small intestine, and all other names of the gastrointestinal tract, peritoneum, and appendix in combination with frozen section. All suitable articles were retrieved and reviewed. This literature search and my personal experience formed the basis of this review.

The role, value, and limitations of frozen section and gross consultation are different for different areas of the gastrointestinal tract, even for the same types of lesions. Close interaction with the surgeon and knowing what is intended from the frozen section, what will be done following a certain diagnosis, and what is the minimal information needed from the pathologist at the time of frozen section are essential for proper patient management.