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Obstructive enterocolitis: a clinico-pathological discussion

T S Levine1, A B Price

  • 1Department of Cellular Pathology, Northwick Park Hospital, Middlesex, UK.

Histopathology
|July 1, 1994
PubMed
Summary
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Obstructive colitis, an underrecognized ulcero-inflammatory lesion proximal to a colonic obstruction, presents diverse pathological findings. This condition, distinct from Crohn's disease or ischemia, may represent a common pathway for intestinal insults.

Area of Science:

  • Gastroenterology
  • Pathology
  • Surgical Pathology

Background:

  • Obstructive colitis is an underrecognized ulcero-inflammatory lesion proximal to a colonic obstruction.
  • It is separated from the obstruction by normal mucosa.
  • This condition presents a spectrum of clinico-pathological features.

Observation:

  • Five surgical cases of obstructive colitis are presented.
  • Presentations included acute intestinal obstruction secondary to adenocarcinoma (4 cases) and diverticular stricture (1 case).
  • Pathological findings ranged from discrete ulcers to extensive colitis, including two novel cases of 'obstructive enteritis'.

Findings:

  • Microscopic examination revealed localized ulceration and active inflammation distinct from Crohn's disease or ischemia.

Related Experiment Videos

  • These inflammatory areas were separated by normal mucosa.
  • The severity of colitis varied significantly among cases.

    • Implications:

    • Obstructive colitis highlights the importance of recognizing specific pathological patterns in gastrointestinal obstruction.
    • The findings suggest mural hypoperfusion and secondary ischemia may play a role in pathogenesis.
    • Colitis indeterminate is proposed as a final common pathway for various intestinal insults, including obstructive and inflammatory processes.