Difference between revisions of "Partial colectomy for diverticular disease"

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[[Image:Sigmoid diverticulum (diagram).jpg|thumb|right|Drawing showing sigmoid diverticula. (WC/Anpol42)]]
'''Partial colectomy for [[diverticular disease]]''' is a very common procedure. The sigmoid colon is typically afflicited; in that case it can more precisely be labeled '''sigmoidectomy for diverticular disease'''.
'''Partial colectomy for [[diverticular disease]]''' is a very common procedure. The sigmoid colon is typically afflicited; in that case it can more precisely be labeled '''sigmoidectomy for diverticular disease'''.
==Introduction==
This is a relatively common specimen.  [[Diverticulitis]] (inflammation of diverticula) and it complications are usually diagnosed by computed tomography (CT).<ref name=pmid27622365>{{Cite journal  | last1 = Schultz | first1 = JK. | last2 = Yaqub | first2 = S. | last3 = Øresland | first3 = T. | title = Management of Diverticular Disease in Scandinavia. | journal = J Clin Gastroenterol | volume = 50 Suppl 1 | issue =  | pages = S50-2 | month = Oct | year = 2016 | doi = 10.1097/MCG.0000000000000642 | PMID = 27622365 }}</ref>
If the individual has a peritonitis, a (temporary) [[stoma]] is created in a surgery known as a ''Hartmann's procedure''.<ref name=pmid27622365/>


The pathologist's main tasks in this specimen is:
The pathologist's main tasks in this specimen is:
#Confirming and documenting extent of the disease.   
#Confirming and documenting extent of the disease.   
#Excluding malignancy.
#Excluding malignancy.
 
==Introduction==
This is quite common.  [[Diverticulitis]] (inflammation of diverticula) and it complications are usually diagnosed by medical imaging.
 
If the individual has a peritonitis, a (temporary) [[stoma]] is generally created.


==Protocol==
==Protocol==
Line 31: Line 32:
*Distal mucosal margin.
*Distal mucosal margin.
*Diverticula (3-5 blocks).
*Diverticula (3-5 blocks).
*Interdiverticular mucosa (2
*Interdiverticular mucosa (2 blocks).
*Lymph nodes (at least 2 blocks).
*Lymph nodes (1 or 2 blocks). ‡


===Protocol notes===
===Protocol notes===
‡ The Royal College of Pathologists (UK) recommends submitting lymph nodes in benign resection.<ref>URL: [https://www.rcpath.org/static/4593f557-d75c-4ca6-9307a9d688e02a2d/g085-tp-giandp-jan16.pdf https://www.rcpath.org/static/4593f557-d75c-4ca6-9307a9d688e02a2d/g085-tp-giandp-jan16.pdf]. Accessed on: 2024 Oct 15.</ref>
===Alternate approaches===
===Alternate approaches===


Latest revision as of 14:01, 15 October 2024

Drawing showing sigmoid diverticula. (WC/Anpol42)

Partial colectomy for diverticular disease is a very common procedure. The sigmoid colon is typically afflicited; in that case it can more precisely be labeled sigmoidectomy for diverticular disease.

Introduction

This is a relatively common specimen. Diverticulitis (inflammation of diverticula) and it complications are usually diagnosed by computed tomography (CT).[1]

If the individual has a peritonitis, a (temporary) stoma is created in a surgery known as a Hartmann's procedure.[1]

The pathologist's main tasks in this specimen is:

  1. Confirming and documenting extent of the disease.
  2. Excluding malignancy.

Protocol

Specimen:

  • Length __ cm.
  • Circumference (proximal/one end) __ cm.
  • Circumference (distal/other end) __ cm.
  • Mesentry (maximal): __ cm.

Appearance:

  • Serosal surface: [shiny/hemorrhagic/dull/exudate/adhesions].
  • Mucosa: [unremarkable/granular].
    • Polyps: [none/number - size __ cm, location (to nearest resection margin): __ cm].
  • Number of diverticula (count up to 6, then estimate): [number of diverticula].
  • Wall: [unremarkable/thickened].

Other:

  • Perforation: [not identified/present - location of perforation (to nearest mucosal margin): __ cm, size of performation __ cm].

Representative sections submitted:

  • Proximal mucosal margin.
  • Distal mucosal margin.
  • Diverticula (3-5 blocks).
  • Interdiverticular mucosa (2 blocks).
  • Lymph nodes (1 or 2 blocks). ‡

Protocol notes

‡ The Royal College of Pathologists (UK) recommends submitting lymph nodes in benign resection.[2]

Alternate approaches

Pathology

  • Diverticular disease.

See also

Related protocols

References

  1. ↑ 1.0 1.1 Schultz, JK.; Yaqub, S.; Øresland, T. (Oct 2016). "Management of Diverticular Disease in Scandinavia.". J Clin Gastroenterol 50 Suppl 1: S50-2. doi:10.1097/MCG.0000000000000642. PMID 27622365.
  2. ↑ URL: https://www.rcpath.org/static/4593f557-d75c-4ca6-9307a9d688e02a2d/g085-tp-giandp-jan16.pdf. Accessed on: 2024 Oct 15.
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