Histopathologic categories of gastrointestinal tract vascular disorders: A review and update

Vascular disorders of the gastrointestinal tract represent a variety of disease processes that impair blood flow or directly damage vessel walls, resulting in ischemia and its consequences. These conditions include thromboembolic disease, systemic vasculitides, drug-induced vascular injury, and structural vascular abnormalities. Histologic features vary among these conditions, with some demonstrating specific identifying findings and others having nonspecific changes that overlap with other diagnoses. While the result is often nonspecific ischemic-type changes, careful histopathologic examination can provide critical diagnostic clues. Integrating these microscopic findings with clinical, laboratory, and radiologic data is essential for accurate diagnosis. This review provides a framework for recognizing the major categories of gastrointestinal vascular pathology to aid surgical pathologists in refining differential diagnoses, avoiding diagnostic misinterpretation, and improving patient care.