Small bowel (small intestine)

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Small bowel (small intestine)

Benign tumors and tumor-like conditions

Ischemia

Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 21 December 2012, last major update August 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Mucosal damage (initially) due to vascular occlusion or reduced blood flow associated with shunting
● Usually not due to atherosclerosis because of widely anastomosing blood supply
● Damage varies from none to hemorrhagic infarction
● Also ulceration, mucosal plaque, strictures
● Grossing bowel specimens with possible ischemia: dissect blood vessels and submit several sections to detect inflammation and thrombosis

Gross images
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Various images

Micro description
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● Early: lamina propria hemorrhage, superficial epithelial necrosis, preservation of deep crypts
● Later: ulceration with minimal inflammation, villous distortion, pyloric gland metaplasia progressing to full thickness infarct
● Late: strictures affecting muscularis propria

Micro images
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Various images

Differential diagnosis
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● Crohn’s disease: marked inflammatory infiltrate, no stricture of muscularis propria, no hemosiderin

Additional references
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● J Med Case Rep 2012;6:48, Histol Histopathol 2010;25:277

End of Small bowel (small intestine) > Benign tumors and tumor-like conditions > Ischemia

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