Details

Colon showing Pseudopolyposis

GC.10508

Histological Glass Slide x1 From a nullipara aged 34, a nurse, who had been troubled with colitis over a period of several years. During the past two years haemorrhage had occurred from the bowel and on two occasions this necessitated large blood transfusions. She was spare and somewhat sallow complexioned, but not markedly anaemic. There was no tenderness or tumour to be made out in the abdomen. Radiographs after a barium enema showed lack of haustration of the distal colon. Sigmoidoscopy revealed numerous long pseudopolypi in the rectum and sigmoid but no ulceration. In view of the recurrent severe bleeding from the bowel colectomy was recommended. At a first stage operation an ileostomy was established and the distal few inches of ileum, proximal colon and part of the descending colon were resected. On the fifth day peritonitis developed and from this she died. At post mortem the peritonitis was seen to be due to a leak from the invaginated end of the descending colon. The preparation consists of the terminal 8 cm. of ileum and the colon to a little distal to the splenic flexure. Throughout the large bowel there are numerous pseudopolypi. In the caecum they are few and widely separated and most numerous in the region of the splenic flexure and upper part of the descending colon. A few pseudopolypi are present in the appendix but none in the terminal ileum. The polypi are slender, variable in length, some being only minute nodules, others reaching a length of 4,5 cm, A considerable number have bifid or trifid extremities. There is little or no evident scarring of the mucosa and no ulceration. The distal part of the colon is narrow, lacks haustration and is surrounded by much subserous fat. The pseudopolypi are covered by ordinary mucosa. Though it is believed that pseudopolyposis predisposes to cancer, it is not a neoplastic lesion.