Endoscopical and histological aspects of inflammatory changes in J-pouch mucosa.
The aim of the study was endoscopic and histological evaluation of mucosal inflammatory changes in the ileal reservoir after restorative proctocolectomy with ileoanal anastomosis (IPAA) because of FAP (27 patients) and ulcerative colitis (34 patients). Endoscopic symptoms of pouchitis (edema, granularity, contact bleeding, loss of vascular pattern, mucus, erosions) were found in 13 patients (4 were operated on because of FAP, 9 because of UC). A statistically significant difference (p < 0.0001) was found between endoscopic inflammatory index in UC (4.0 +/- 0.5) and in FAP (1.00 +/- 0.00). The endoscopic changes were correlated with the Moskowitz histological classification, in 12 acute score and in 6 chronic score were above 4 points. In 18 patients histological diagnosis of pouchitis was made (5 in FAP, 13 in UC). Acute pouchitis occurred in 12 patients and chronic in 6. In one patient histological changes resembled Crohn's disease. Regular endoscopic control with histological examination and verification of inflammatory lesions in the ileal reservoir is necessary.
Marciniak
R
R
III Department of Surgery, K. Marcinkowski University of Medical Sciences, Poznań. rmarcin@mail.usoms.poznan.pl
Majewski
P
P
Drews
M
M
Krokowicz
P
P
Lange
M
M
Banasiewicz
T
T
Janicka-Jedyńska
M
M
Malinger
S
S
D011125:Adenomatous Polyposis Coli / Q000601:surgery; D001706:Biopsy; D003093:Colitis, Ulcerative / Q000601:surgery; D003113:Colonoscopy; D006801:Humans; D007082:Ileum / Q000473:pathology; D007413:Intestinal Mucosa / Q000473:pathology*; D011183:Postoperative Complications / Q000473:pathology*; D019449:Pouchitis / Q000473:pathology*; D016737:Proctocolectomy, Restorative