Importance of biopsies and histological evaluation in patients with chronic diarrhea and normal colonoscopies

Abstract

BackgroundIn patients with chronic diarrhea, colonoscopy may identify inflammatory causes or some occult disease, and also can show a normal mucosa. Serial biopsies of intestinal mucosa can be useful for a differential diagnosis, and to modify the treatment.AimTo evaluate whether the biopsies performed in patients with chronic diarrhea and a normal colonoscopy contribute to the differential diagnosis and alter the therapeutic approach.MethodsA descriptive, retrospective and cross-sectional study using a computerized database was done. Patients with chronic diarrhea and a normal colonoscopy underwent serial biopsies of the terminal ileum, ascending colon and rectum.ResultsFrom 398 records, 214 were excluded. Of the 184 patients enrolled, 91 showed histological changes: 40% nonspecific inflammation; 5.18% lymphocytic inflammation, 10.37% eosinophilic inflammation; 39.26% lymphoid hyperplasia; 2.22% collagenous colitis; 2.22% melanosis; and 0.74% pseudomelanose. The sites with the largest number of changes were the terminal ileum and right colon.ConclusionsSerial biopsies in patients with chronic diarrhea and normal colonoscopy identified changes in almost 50% of cases and 22% of these cases may had modified the treatment after identification of collagenous, lymphocytic and eosinophilic colitis.

Role of Mucosal Colonic Biopsy in Patients with Chronic Unexplained Diarrhoea who their Colonoscopy is Normal

“…As Fine and Schiller reported that serial biopsy helps in establishing a histopathological diagnosis in 15% of patients with diarrhoea lasting over four weeks [13]. Also, Kagueyama reported that patients with diarrhoea lasting 15-30 days displayed a high incidence of hitological changes [10].…”

Tissue microarray technology and collagen evaluation to analyze surgical trauma performed with usual blade or ultrasonic harmonic scalpels in rats

“…This statement was also confirmed in this study. Other authors argue that conventional scalpel produces leakage of blood and lymph causing greater swelling and scarring 11,[17][18][19] .…”

Avaliação da eficácia de três marcadores imunoistoquímicos envolvidos nos diferentes tempos da cicatrização da ferida cirúrgica

“…Following the schedule, weeuthanized them by intraperitoneal injection of anesthetics at twice the usual anestheticdose. Once the death was confirmed, we analyzed the abdominal wall to check for complications such as hematoma, infection, suture dehiscence and adhesions 12,13 . Afterwards, we made the skin and subcutaneous incision in the cranial-caudal direction, with resection of the entire ventral wall in 8x6 cm, encompassing the entire incision.…”