Spectrum of pathologies in cases of intestinal obstruction & perforation based on histopathological examination of resected intestine - Report from a third world country.
OBJECTIVE
Cases presenting with intestinal perforation and obstruction constitute a substantial work load on our surgical service. Etiologies vary in underdeveloped and developed countries. Histopathological examination of resected intestine is expected to provide the definite evidence of the underlying etiology- guiding a better health care planning for preventive measures. Our objective was to study the spectrum of histopathological findings in resected intestines from cases of intestinal obstruction and perforation in our local population to document the underlying etiology.


METHODS
A total of 120 cases of intestinal resection were included. Detailed gross and microscopic examination with routine stains was performed. Definite evidence of any specific etiology on the basis of morphology was documented.


RESULTS
A total of 95 cases with clinical/radiological diagnosis of obstruction (79.2%) and 25 of intestinal, perforation (20.8%) were included. Tuberculous enteritis was the commonest etiology (n=41; 43.1%) in cases of intestinal obstruction followed by malignant tumours (n=30; 31.5%). ischemic infarct/gangrene, post op illeal adhesions, polyps and ulcerative colitis followed. In cases of perforation, Typhoid enteritis (n=15; 60%), was the commonest pathology followed by idiopathic perforation (n=5; 20%), tuberculous enteritis (n=3;12%), carcinoma (4%) and ulcerative coliti (4%). Conclusion : In developing countries infective etiology remains a dominant cause of intestinal obstruction and perforation. Its presentation in younger age leading to intestinal resection demands effective preventive measures in this part of the world to prevent morbidity and mortality.
Noshin Wasim Yusuf, Head and Professor, Department of Pathology, Allama Iqbal Medical College, Lahore, Pakistan.
Noshin
N
Wasim Yusuf
Sehr Iqbal, Lecturer, Department of Pathology, Allama Iqbal Medical College, Lahore, Pakistan.
Sehr
S
Iqbal
Rahat Sarfraz, Associate Professor, Department of Pathology, Allama Iqbal Medical College, Lahore, Pakistan.
Rahat
R
Sarfraz
Shezada Khalid Sohail, Consultant Histopathologist, Department of Pathology, Allama Iqbal Medical College, Lahore, Pakistan.
Shezada
S
Khalid Sohail
Mohammad Imran, Consultant Histopathologist, Department of Pathology, Allama Iqbal Medical College, Lahore, Pakistan.
Mohammad
M
Imran
Intestinal resection; Perforation; Polyps; Tuberculous enteritis