Inflammatory bowel disease - Revision history

Michael at 17:09, 16 February 2019

2019-02-16T17:09:32Z

← Older revision		Revision as of 17:09, 16 February 2019
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	**Generally, pouches are ''not'' used in Crohn's disease.		**Generally, pouches are ''not'' used in Crohn's disease.
	*Chronic pouchitis seen in approximately 15% of patients.<ref name=pmid12617884 >{{Cite journal \| last1 = Gionchetti \| first1 = P. \| last2 = Amadini \| first2 = C. \| last3 = Rizzello \| first3 = F. \| last4 = Venturi \| first4 = A. \| last5 = Poggioli \| first5 = G. \| last6 = Campieri \| first6 = M. \| title = Diagnosis and treatment of pouchitis. \| journal = Best Pract Res Clin Gastroenterol \| volume = 17 \| issue = 1 \| pages = 75-87 \| month = Feb \| year = 2003 \| doi = \| PMID = 12617884 }}</ref>		*Chronic pouchitis seen in approximately 15% of patients.<ref name=pmid12617884 >{{Cite journal \| last1 = Gionchetti \| first1 = P. \| last2 = Amadini \| first2 = C. \| last3 = Rizzello \| first3 = F. \| last4 = Venturi \| first4 = A. \| last5 = Poggioli \| first5 = G. \| last6 = Campieri \| first6 = M. \| title = Diagnosis and treatment of pouchitis. \| journal = Best Pract Res Clin Gastroenterol \| volume = 17 \| issue = 1 \| pages = 75-87 \| month = Feb \| year = 2003 \| doi = \| PMID = 12617884 }}</ref>
	*May be assessed by fecal calprotectin.<ref name=pmid18301296>{{Cite journal \| last1 = Johnson \| first1 = MW. \| last2 = Maestranzi \| first2 = S. \| last3 = Duffy \| first3 = AM. \| last4 = Dewar \| first4 = DH. \| last5 = Forbes \| first5 = A. \| last6 = Bjarnason \| first6 = I. \| last7 = Sherwood \| first7 = RA. \| last8 = Ciclitira \| first8 = P. \| last9 = Nicholls \| first9 = JR. \| title = Faecal calprotectin: a noninvasive diagnostic tool and marker of severity in pouchitis. \| journal = Eur J Gastroenterol Hepatol \| volume = 20 \| issue = 3 \| pages = 174-9 \| month = Mar \| year = 2008 \| doi = 10.1097/MEG.0b013e3282f1c9a7 \| PMID = 18301296 }}</ref>		*May be assessed by [[fecal calprotectin]].<ref name=pmid18301296>{{Cite journal \| last1 = Johnson \| first1 = MW. \| last2 = Maestranzi \| first2 = S. \| last3 = Duffy \| first3 = AM. \| last4 = Dewar \| first4 = DH. \| last5 = Forbes \| first5 = A. \| last6 = Bjarnason \| first6 = I. \| last7 = Sherwood \| first7 = RA. \| last8 = Ciclitira \| first8 = P. \| last9 = Nicholls \| first9 = JR. \| title = Faecal calprotectin: a noninvasive diagnostic tool and marker of severity in pouchitis. \| journal = Eur J Gastroenterol Hepatol \| volume = 20 \| issue = 3 \| pages = 174-9 \| month = Mar \| year = 2008 \| doi = 10.1097/MEG.0b013e3282f1c9a7 \| PMID = 18301296 }}</ref>
	*Considered a clinico-pathologic diagnosis.<ref name=pmid20958905>{{Cite journal \| last1 = Royston \| first1 = DJ. \| last2 = Warren \| first2 = BF. \| title = Are we reporting ileal pouch biopsies correctly? \| journal = Colorectal Dis \| volume = 13 \| issue = 11 \| pages = 1285-9 \| month = Nov \| year = 2011 \| doi = 10.1111/j.1463-1318.2010.02452.x \| PMID = 20958905 }}</ref><ref name=pmid12617884 >{{Cite journal \| last1 = Gionchetti \| first1 = P. \| last2 = Amadini \| first2 = C. \| last3 = Rizzello \| first3 = F. \| last4 = Venturi \| first4 = A. \| last5 = Poggioli \| first5 = G. \| last6 = Campieri \| first6 = M. \| title = Diagnosis and treatment of pouchitis. \| journal = Best Pract Res Clin Gastroenterol \| volume = 17 \| issue = 1 \| pages = 75-87 \| month = Feb \| year = 2003 \| doi = \| PMID = 12617884 }}</ref>		*Considered a clinico-pathologic diagnosis.<ref name=pmid20958905>{{Cite journal \| last1 = Royston \| first1 = DJ. \| last2 = Warren \| first2 = BF. \| title = Are we reporting ileal pouch biopsies correctly? \| journal = Colorectal Dis \| volume = 13 \| issue = 11 \| pages = 1285-9 \| month = Nov \| year = 2011 \| doi = 10.1111/j.1463-1318.2010.02452.x \| PMID = 20958905 }}</ref><ref name=pmid12617884 >{{Cite journal \| last1 = Gionchetti \| first1 = P. \| last2 = Amadini \| first2 = C. \| last3 = Rizzello \| first3 = F. \| last4 = Venturi \| first4 = A. \| last5 = Poggioli \| first5 = G. \| last6 = Campieri \| first6 = M. \| title = Diagnosis and treatment of pouchitis. \| journal = Best Pract Res Clin Gastroenterol \| volume = 17 \| issue = 1 \| pages = 75-87 \| month = Feb \| year = 2003 \| doi = \| PMID = 12617884 }}</ref>
	===Microscopic===		===Microscopic===

Michael: /* "Indeterminate colitis" */

2016-11-22T15:48:32Z

"Indeterminate colitis"

← Older revision		Revision as of 15:48, 22 November 2016
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	#CUTE = Colitis of uncertain type or etiology.		#CUTE = Colitis of uncertain type or etiology.
	#*Should be reserved for resection specimens only.		#*Should be reserved for resection specimens only.



	==Dysplasia in inflammatory bowel disease==		==Dysplasia in inflammatory bowel disease==

Michael: /* Biopsies all submitted it all in one bottle */

2015-06-11T18:32:03Z

Biopsies all submitted it all in one bottle

← Older revision		Revision as of 18:32, 11 June 2015
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	*Surveillance biopsies should specify the (anatomical) site - so, it possible to find any site of interest on a follow-up colonoscopy.<ref name=pmid16609751>{{Cite journal \| last1 = Panaccione \| first1 = R. \| title = The approach to dysplasia surveillance in inflammatory bowel disease. \| journal = Can J Gastroenterol \| volume = 20 \| issue = 4 \| pages = 251-3 \| month = Apr \| year = 2006 \| doi = \| PMID = 16609751 \| PMC = 2659899}}</ref>		*Surveillance biopsies should specify the (anatomical) site - so, it possible to find any site of interest on a follow-up colonoscopy.<ref name=pmid16609751>{{Cite journal \| last1 = Panaccione \| first1 = R. \| title = The approach to dysplasia surveillance in inflammatory bowel disease. \| journal = Can J Gastroenterol \| volume = 20 \| issue = 4 \| pages = 251-3 \| month = Apr \| year = 2006 \| doi = \| PMID = 16609751 \| PMC = 2659899}}</ref>

	===Biopsies all submitted ~~it all~~ in one bottle===		===Biopsies all submitted in one bottle===
	<pre>		<pre>
	COLON (SITE NOT FURTHER SPECIFIED), BIOPSIES:		COLON (SITE NOT FURTHER SPECIFIED), BIOPSIES:

Michael: /* Ulcerative colitis */

2015-02-21T16:56:27Z

Ulcerative colitis

Show changes

Michael: /* Dysplasia-associated lesion or mass */ split out

2014-09-04T19:22:09Z

Dysplasia-associated lesion or mass: split out

← Older revision		Revision as of 19:22, 4 September 2014
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	==Dysplasia-associated lesion or mass==		==Dysplasia-associated lesion or mass==
	*Abbreviated ''DALM''.		*Abbreviated ''DALM''.
	~~===General===~~		{{Main\|Dysplasia-associated lesion or mass}}
	*Proving invasive malignancy (on histopathologic grounds alone) in the setting of chronic inflammation is difficult.<ref name=pmid7450425>{{~~Cite journal~~ \| ~~last1 = Blackstone \| first1 = MO. \| last2 = Riddell \| first2 = RH. \| last3 = Rogers \| first3 = BH. \| last4 = Levin \| first4 = B. \| title =~~ Dysplasia-associated lesion or mass (DALM) detected by colonoscopy in long-standing ulcerative colitis: an indication for colectomy. \| journal = Gastroenterology \| volume = 80 \| issue = 2 \| pages = 366-74 \| month = Feb \| year = 1981 \| doi = \| PMID = 7450425 }}</ref>
	*This diagnosis depends on correlation of endoscopy and histopathology - '''important'''.<ref name=pmid21912466>{{Cite journal \| last1 = Neumann \| first1 = H. \| last2 = Vieth \| first2 = M. \| last3 = Langner \| first3 = C. \| last4 = Neurath \| first4 = MF. \| last5 = Mudter \| first5 = J. \| title = Cancer risk in IBD: how to diagnose and how to manage DALM and ALM. \| journal = World J Gastroenterol \| volume = 17 \| issue = 27 \| pages = 3184-91 \| month = Jul \| year = 2011 \| doi = 10.3748/wjg.v17.i27.3184 \| PMID = 21912466 }}</ref>
	**Biopsies are usually taken of the lesion and around the base.
	*Historically, this diagnosis lead to [[colectomy]].
	**It may be managed endoscopically in the context of modern endoscopy.<ref>{{Cite journal \| last1 = East \| first1 = JE. \| last2 = Toyonaga \| first2 = T. \| last3 = Suzuki \| first3 = N. \| title = Endoscopic management of nonpolypoid colorectal lesions in colonic IBD. \| journal = Gastrointest Endosc Clin N Am \| volume = 24 \| issue = 3 \| pages = 435-45 \| month = Jul \| year = 2014 \| doi = 10.1016/j.giec.2014.03.003 \| PMID = 24975534 }}
	~~</ref>~~

	~~===Gross===~~
	*Endoscopically "suspicious", i.e. endoscopist thinks this is a DALM - '''essential feature'''.
	**Usually have a positive lifting sign.

	~~===Microscopic===~~
	~~Features:~~
	*Cytologic dysplasia - as in [[adenomatous polyps]] - '''key feature'''.
	*Flat or polypoid.<ref name=pmid7450425/>

	~~DDx:~~
	*Sporadic [[adenomatous polyp]] -- favouring sporadic:
	**Sharp transition between lesion and the surrounding tissue.<ref name=pmid21912466/>
	**Polyps not at site of active disease.<ref name=pmid10746669>{{Cite journal \| last1 = Fogt \| first1 = F. \| last2 = Urbanski \| first2 = SJ. \| last3 = Sanders \| first3 = ME. \| last4 = Furth \| first4 = EE. \| last5 = Zimmerman \| first5 = RL. \| last6 = Deren \| first6 = JJ. \| last7 = Noffsinger \| first7 = AE. \| last8 = Vortmeyer \| first8 = AO. \| last9 = Hartmann \| first9 = CJ. \| title = Distinction between dysplasia-associated lesion or mass (DALM) and adenoma in patients with ulcerative colitis. \| journal = Hum Pathol \| volume = 31 \| issue = 3 \| pages = 288-91 \| month = Mar \| year = 2000 \| doi = \| PMID = 10746669 }}~~</ref>~~

	~~Image:~~
	*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3158393/figure/F7/ DALM (nlm.nih.gov)].<ref name=pmid21912466/>

	==Pouchitis==		==Pouchitis==

Michael: /* Dysplasia-associated lesion or mass */

2014-09-04T17:20:08Z

Dysplasia-associated lesion or mass

← Older revision		Revision as of 17:20, 4 September 2014
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	*This diagnosis depends on correlation of endoscopy and histopathology - '''important'''.<ref name=pmid21912466>{{Cite journal \| last1 = Neumann \| first1 = H. \| last2 = Vieth \| first2 = M. \| last3 = Langner \| first3 = C. \| last4 = Neurath \| first4 = MF. \| last5 = Mudter \| first5 = J. \| title = Cancer risk in IBD: how to diagnose and how to manage DALM and ALM. \| journal = World J Gastroenterol \| volume = 17 \| issue = 27 \| pages = 3184-91 \| month = Jul \| year = 2011 \| doi = 10.3748/wjg.v17.i27.3184 \| PMID = 21912466 }}</ref>		*This diagnosis depends on correlation of endoscopy and histopathology - '''important'''.<ref name=pmid21912466>{{Cite journal \| last1 = Neumann \| first1 = H. \| last2 = Vieth \| first2 = M. \| last3 = Langner \| first3 = C. \| last4 = Neurath \| first4 = MF. \| last5 = Mudter \| first5 = J. \| title = Cancer risk in IBD: how to diagnose and how to manage DALM and ALM. \| journal = World J Gastroenterol \| volume = 17 \| issue = 27 \| pages = 3184-91 \| month = Jul \| year = 2011 \| doi = 10.3748/wjg.v17.i27.3184 \| PMID = 21912466 }}</ref>
	**Biopsies are usually taken of the lesion and around the base.		**Biopsies are usually taken of the lesion and around the base.
	*Historically, this diagnosis lead to [[colectomy]]. It may be managed endoscopically.{{~~fact~~}}		*Historically, this diagnosis lead to [[colectomy]].
			**It may be managed endoscopically in the context of modern endoscopy.<ref>{{Cite journal \| last1 = East \| first1 = JE. \| last2 = Toyonaga \| first2 = T. \| last3 = Suzuki \| first3 = N. \| title = Endoscopic management of nonpolypoid colorectal lesions in colonic IBD. \| journal = Gastrointest Endosc Clin N Am \| volume = 24 \| issue = 3 \| pages = 435-45 \| month = Jul \| year = 2014 \| doi = 10.1016/j.giec.2014.03.003 \| PMID = 24975534 }}
			</ref>

	===Gross===		===Gross===

Michael: /* Dysplasia-associated lesion or mass */

2014-09-04T17:09:27Z

Dysplasia-associated lesion or mass

← Older revision		Revision as of 17:09, 4 September 2014
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	*This diagnosis depends on correlation of endoscopy and histopathology - '''important'''.<ref name=pmid21912466>{{Cite journal \| last1 = Neumann \| first1 = H. \| last2 = Vieth \| first2 = M. \| last3 = Langner \| first3 = C. \| last4 = Neurath \| first4 = MF. \| last5 = Mudter \| first5 = J. \| title = Cancer risk in IBD: how to diagnose and how to manage DALM and ALM. \| journal = World J Gastroenterol \| volume = 17 \| issue = 27 \| pages = 3184-91 \| month = Jul \| year = 2011 \| doi = 10.3748/wjg.v17.i27.3184 \| PMID = 21912466 }}</ref>		*This diagnosis depends on correlation of endoscopy and histopathology - '''important'''.<ref name=pmid21912466>{{Cite journal \| last1 = Neumann \| first1 = H. \| last2 = Vieth \| first2 = M. \| last3 = Langner \| first3 = C. \| last4 = Neurath \| first4 = MF. \| last5 = Mudter \| first5 = J. \| title = Cancer risk in IBD: how to diagnose and how to manage DALM and ALM. \| journal = World J Gastroenterol \| volume = 17 \| issue = 27 \| pages = 3184-91 \| month = Jul \| year = 2011 \| doi = 10.3748/wjg.v17.i27.3184 \| PMID = 21912466 }}</ref>
	**Biopsies are usually taken of the lesion and around the base.		**Biopsies are usually taken of the lesion and around the base.
	*~~This~~ diagnosis ~~usually leads~~ to a [[colectomy]].		*Historically, this diagnosis lead to [[colectomy]]. It may be managed endoscopically.{{fact}}

	===Gross===		===Gross===

Michael: /* Sign out */

2014-09-04T17:07:44Z

Sign out

← Older revision		Revision as of 17:07, 4 September 2014
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	===Sign out===		===Sign out===
			Note:
			*Dr. Robert Riddell is of the opinion: "Do '''not''' call any pouch inflammation as consistent with Crohn's disease."

	<pre>		<pre>
	SMALL BOWEL POUCH, BIOPSY:		SMALL BOWEL POUCH, BIOPSY:

Michael: /* Images */

2014-06-20T13:06:33Z

Images

← Older revision		Revision as of 13:06, 20 June 2014
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	====Images====		====Images====
	<gallery>		<gallery>
	Image:Crohn%27s_disease_-_colon_-_high_mag.jpg \| Crohn's disease - ~~beautiful~~ granulomas in the colon - high mag. (WC)		Image:Crohn%27s_disease_-_colon_-_high_mag.jpg \| Crohn's disease - very well-formed granulomas in the [[colon]] - high mag. (WC)
	Image:Crohn%27s_disease_-_duodenum_-_intermed_mag.jpg \| Crohn's disease - duodenum - intermed. mag. (WC)		Image:Crohn%27s_disease_-_duodenum_-_intermed_mag.jpg \| Crohn's disease - duodenum - intermed. mag. (WC)
	Image: Cryptitis_-_alt_--_very_high_mag.jpg \| Cryptitis. (WC)		Image: Cryptitis_-_alt_--_very_high_mag.jpg \| Cryptitis. (WC)
	Image:Crypt_branching_high_mag.jpg \| Crypt branching. (WC)		Image:Crypt_branching_high_mag.jpg \| Crypt branching. (WC)
	</gallery>		</gallery>

	===Grading===		===Grading===
	*Several systems exists.<ref name=Kirsch>Kirsch, R. 13 December 2010.</ref>		*Several systems exists.<ref name=Kirsch>Kirsch, R. 13 December 2010.</ref>

Michael: /* Dysplasia in inflammatory bowel disease */

2014-05-21T20:15:08Z

Dysplasia in inflammatory bowel disease

← Older revision		Revision as of 20:15, 21 May 2014
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	Notes:		Notes:
	*GI experts and generalists have similar rates agreement.<ref name=pmid11400142>{{Cite journal \| last1 = Eaden \| first1 = J. \| last2 = Abrams \| first2 = K. \| last3 = McKay \| first3 = H. \| last4 = Denley \| first4 = H. \| last5 = Mayberry \| first5 = J. \| title = Inter-observer variation between general and specialist gastrointestinal pathologists when grading dysplasia in ulcerative colitis. \| journal = J Pathol \| volume = 194 \| issue = 2 \| pages = 152-7 \| month = Jun \| year = 2001 \| doi = 10.1002/path.876 \| PMID = 11400142 }}</ref>		*GI experts and generalists have similar rates of agreement.<ref name=pmid11400142>{{Cite journal \| last1 = Eaden \| first1 = J. \| last2 = Abrams \| first2 = K. \| last3 = McKay \| first3 = H. \| last4 = Denley \| first4 = H. \| last5 = Mayberry \| first5 = J. \| title = Inter-observer variation between general and specialist gastrointestinal pathologists when grading dysplasia in ulcerative colitis. \| journal = J Pathol \| volume = 194 \| issue = 2 \| pages = 152-7 \| month = Jun \| year = 2001 \| doi = 10.1002/path.876 \| PMID = 11400142 }}</ref>

	===Microscopic===		===Microscopic===