Khalil Ullah, Arshad Hussain, Asghar Aurangzeb Durrani.
The spectrum of disease in lower gastrointestinal tract: Endoscopic biopsy findings.
J Coll Physicians Surg Pak Jan ;11(7):443-8.

Objective: To evaluate the morphological spectrum of colonic disease and its clinical presentation in our patients from hospitals in and around Rawalpindi / Islamabad. Design: A retrospective data based study. Place and Duration of Study: Pathology Department of Army Medical College, Rawalpindi. Material and Methods: The colonic mucosal biopsies of 1268 patients received during the period of 1980-1995 were studied by routine histopathology methods. Results: A higher frequency of colonic disease in males with a male to female ratio of 2.6:1 and an age range of 1.25 months to 80 years was observed. The clinical presentations mostly seen were bleeding per rectum (32.71 %), mass abdomen (23.86%), diarrheal episodes (18.62%), constipation (13.38%) and bloody diarrhea (3.02%). The major radiological diagnosis available in 71 cases was ulcerative colitis (32.39%), colonic growth (21.12%) and polyps (11.26%). On endoscopy the most frequently suspected lesions were polyps (34.70%), colonic growth (29.16%), ulcerative colitis (11.66%) and nonspecific findings (9.23%), while 11.23% cases showed unremarkable mucosa. The histopathology revealed mostly nonspecific colitis (25.23%), followed by polyps (24.13%), colonic cancer (17.11 %), ulcerative colitis (11.19%) and colonic aganglionosis (6.54%). A small number of cases of amoebic, eosinophilic and collagenous colitis and Crohn`s disease was also seen. A number of biopsies (6.30%) were unremarkable histologically. Conclusion: Anorectosigmoid was the most commonly involved site than rest of the colon with a ratio of 2.43:1 and therefore most lesions were within the reach of rectosigmoidoscope.

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