Toolenaar T A, Freundt I, Huikeshoven F J, Drogendijk A C, Jeekel H, Chadha-Ajwani S
Department of Obstetrics and Gynecology, Academic Hospital Rotterdam, Dijkzigt, The Netherlands.
Hum Pathol. 1993 Aug;24(8):846-9. doi: 10.1016/0046-8177(93)90134-3.
Diversion colitis is an inflammatory process occurring in segments of the colorectum surgically diverted from the fecal stream. Clinical symptoms of this condition are rectal discomfort, pain, discharge, and bleeding. We diverted isolated segments of sigmoid to create neovaginas in patients with aplasia vaginae and in male to female transsexuals. In contrast to what is reported in most studies of diversion colitis, the neovagina consists of an isolated segment not connected to the anus in patients without any pre-existing bowel disease. To investigate the occurrence of diversion colitis in these sigmoid-neovaginas we studied biopsy specimens from 13 patients. Most of the patients complained of discharge and slight blood loss from their sigmoid-neovagina. Microscopic examination of the biopsy specimens showed lymphocytic infiltration in all cases. Four cases showed an acute inflammatory infiltrate in the lamina propria. Our results indicate that the changes observed on clinical and histopathologic examinations represent the entity of mild diversion colitis. We conclude that diversion colitis also occurs in a sigmoid neovagina.
改道性结肠炎是一种发生在因手术而改道远离粪便流的结直肠节段的炎症过程。这种病症的临床症状包括直肠不适、疼痛、分泌物和出血。我们将乙状结肠的孤立节段改道，为先天性阴道发育不全患者和男变女的变性者创建新阴道。与大多数改道性结肠炎研究中所报道的情况不同，在没有任何既往肠道疾病的患者中，新阴道由一个与肛门不相连的孤立节段构成。为了研究这些乙状结肠新阴道中改道性结肠炎的发生情况，我们研究了13例患者的活检标本。大多数患者抱怨其乙状结肠新阴道有分泌物和少量失血。活检标本的显微镜检查显示所有病例均有淋巴细胞浸润。4例在固有层有急性炎症浸润。我们的结果表明，临床和组织病理学检查中观察到的变化代表了轻度改道性结肠炎这一实体。我们得出结论，改道性结肠炎也发生在乙状结肠新阴道中。
