Clinicopathological Re-analysis of Enterocolitis Indeterminate (Unclassified) Hidenobu Watanabe 1 , Yoichi Ajioka 1 , Tamaki Ohta 1 1The First Department of Pathology, Niigata University School of Medicine pp.1105-1117
Published Date 1989/10/25
DOI https://doi.org/10.11477/mf.1403106582
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 Enterocolitis indeterminate accounted for 2.0% (17/852) of surgically resected small and large intestines at the first pathological examination. The proportion, however, decreased to 0.5% (4/852) when reexamined clinicopathologically, i.e., 76% (13/17) of the cases once classified into enterocolitis indeterminate were put into one of the known inflammatory bowel diseases.

 Revised diagnoses were as follows: bacterial infective (entero-) colitis (8 cases), ischemic colitis (1), simple ulcer (1), tuberculosis (1), ulcerative colitis (1) and Yersinial infection (1). The remaining unclassifiable colitis (4 cases) were described as follows: completely healed mucosal lesion (1 case), active colitis with a circular and three oval shallow ulcers on the ileocecal valve (2), and multiple sessile and round to oval caterpillar-like polyps with smooth red surface in the sigmoid colon and rectum (1). The last one or two pathological findings may lead to new categories of inflammatory bowel diseases.

 Seventy-six percent of misclassifications occurred at the first pathological examination because of pathologists' poor knowledge on inflammatory bowel diseases or methodologically inadequate and inaccurate examination. Misclassifications in the rest of the cases were due to the lack of pathognomonic findings of the known bowel diseases which had already healed completely or developed complications.

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