spectrum of disease in lower gastrointestinal tract: endoscopic biopsy findings

ABSTRACT

To evaluate the morphological spectrum of colonic disease and its clinical presentation in our patients from hospitals in and around Rawalpindi / Islamabad. Design: A retrospective data based study. Place and Duration of Study Pathology Department of Army Medical College, Rawalpindi. Material and The colonic mucosal biopsies of 1268 patients received during the period of 1980-1995 were studied by routine histopathology methods. A higher frequency of colonic disease in males with a male to female ratio of 2.61 and an age range of 1.25 months to 80 years was observed. The clinical presentations mostly seen were bleeding per rectum [32.71%], mass abdomen [23.86%], diarrheal episodes [18.62%], constipation [13.38%] and bloody diarrhea [3.02%]. The major radiological diagnosis available in 71 cases was ulcerative colitis [32.39%], colonic growth [21.12%] and polyps [11.26%]. On endoscopy the most frequently suspected lesions were polyps [34.70%], colonic growth [29.16%], ulcerative colitis [11.66%] and nonspecific findings [9.23%], while 11.23% cases showed unremarkable mucosa. The histopathology revealed mostly nonspecific colitis [25.23%], followed by polyps [24.13%], colonic cancer [17.11%], ulcerative colitis [11.19%] and colonic aganglionosis [6.54%]. A small number of cases of amoebic, eosinophilic and collagenous colitis and Crohn's disease was also seen. A number of biopsies [6.30%] were unremarkable histologically. Anorectosigmoid was the most commonly involved site than rest of the colon with a ratio of 2.431 and therefore most lesions were within the reach of rectosigmoidoscope