Location
Moultrie, GA
Start Date
9-5-2023 1:00 PM
End Date
9-5-2023 4:00 PM
Description
Introduction
Colonic stenosis is commonly caused by chronic inflammation and is a known side effect of inflammatory conditions, such as diverticulitis and irritable bowel syndrome. Diverticulosis is a common condition where parts of the colon wall become weakened, forming outpouches. These outpouchings may become inflamed, leading to diverticulitis. This chronic inflammation can cause scarring and fibrosis of the colon, resulting in colonic stenosis. Inflammatory bowel diseases, such as Crohn’s disease and ulcerative colitis, may also result in scarring and colonic stenosis. The incidence rate of patients developing colonic stenosis is 8-13.5% for Crohn's disease and 1-11% for ulcerative colitis. Patients with colonic stenosis often experience bloating, constipation, abdominal discomfort, and reduced bowel movements. Although rarely diagnosed, diagnosis is typically made during surgical procedures or with CT imaging. If diagnosed, treatment includes surgical removal of the narrowed or blocked colon and attachment of the healthy ends together with sutures. This study aims to determine the underlying cause of colonic stenosis in a deceased 83-year-old Caucasian female. Did the colonic stenosis cause diverticulosis or did the diverticulitis cause the colonic stenosis? Based on how extensive the diverticulitis is in this patient, we predict her colonic stenosis was most likely caused by her diverticulitis.
Methods
A cadaver used in routine dissection in the Gross Anatomy laboratory at the Philadelphia College of Osteopathic Medicine, South Georgia campus was studied. Samples were taken from the transverse and descending colon for histopathological evaluation and sent to the Colquitt Regional Medical Center for processing. Slides were stained by Hematoxylin and Eosin staining and reported by a pathologist.
Results
Gross colon examination showed an obvious narrowing of the transverse, descending, and sigmoid colon indicating colonic stenosis. Also noted were multiple diverticula. Microscopic findings confirmed diverticulosis's multiple outpouchings and revealed chronic inflammatory cells consistent with diverticulitis.
Discussion
Colonic histopathology revealed aggregates of chronic inflammatory lymphocytes and small dilated outpouchings in the colonic wall, indicating diverticulitis and diverticulosis, respectively. More testing will need to be performed to determine if there is generalized inflammation which would suggest a form of irritable bowel syndrome. If the walls of the bowel are significantly thickened, this may suggest irritable bowel syndrome, which might have been the cause of her colonic stenosis. Obtaining the patient’s medical history would be a vital aspect of understanding the cause of her colonic stenosis by better understanding the patient’s lifestyle and dietary habits. However, this was a limitation of our study. In our case, diverticulitis might have been a complication of the extra pressure in the colon from the stenosis, and the diverticulosis was most probably a complication of colonic stenosis.
Embargo Period
1-11-2024
Included in
Colonic Stenosis in an elderly female
Moultrie, GA
Introduction
Colonic stenosis is commonly caused by chronic inflammation and is a known side effect of inflammatory conditions, such as diverticulitis and irritable bowel syndrome. Diverticulosis is a common condition where parts of the colon wall become weakened, forming outpouches. These outpouchings may become inflamed, leading to diverticulitis. This chronic inflammation can cause scarring and fibrosis of the colon, resulting in colonic stenosis. Inflammatory bowel diseases, such as Crohn’s disease and ulcerative colitis, may also result in scarring and colonic stenosis. The incidence rate of patients developing colonic stenosis is 8-13.5% for Crohn's disease and 1-11% for ulcerative colitis. Patients with colonic stenosis often experience bloating, constipation, abdominal discomfort, and reduced bowel movements. Although rarely diagnosed, diagnosis is typically made during surgical procedures or with CT imaging. If diagnosed, treatment includes surgical removal of the narrowed or blocked colon and attachment of the healthy ends together with sutures. This study aims to determine the underlying cause of colonic stenosis in a deceased 83-year-old Caucasian female. Did the colonic stenosis cause diverticulosis or did the diverticulitis cause the colonic stenosis? Based on how extensive the diverticulitis is in this patient, we predict her colonic stenosis was most likely caused by her diverticulitis.
Methods
A cadaver used in routine dissection in the Gross Anatomy laboratory at the Philadelphia College of Osteopathic Medicine, South Georgia campus was studied. Samples were taken from the transverse and descending colon for histopathological evaluation and sent to the Colquitt Regional Medical Center for processing. Slides were stained by Hematoxylin and Eosin staining and reported by a pathologist.
Results
Gross colon examination showed an obvious narrowing of the transverse, descending, and sigmoid colon indicating colonic stenosis. Also noted were multiple diverticula. Microscopic findings confirmed diverticulosis's multiple outpouchings and revealed chronic inflammatory cells consistent with diverticulitis.
Discussion
Colonic histopathology revealed aggregates of chronic inflammatory lymphocytes and small dilated outpouchings in the colonic wall, indicating diverticulitis and diverticulosis, respectively. More testing will need to be performed to determine if there is generalized inflammation which would suggest a form of irritable bowel syndrome. If the walls of the bowel are significantly thickened, this may suggest irritable bowel syndrome, which might have been the cause of her colonic stenosis. Obtaining the patient’s medical history would be a vital aspect of understanding the cause of her colonic stenosis by better understanding the patient’s lifestyle and dietary habits. However, this was a limitation of our study. In our case, diverticulitis might have been a complication of the extra pressure in the colon from the stenosis, and the diverticulosis was most probably a complication of colonic stenosis.