Clinical Features and Histopathologic Distribution of Granuloma in Colonoscopy Biopsy
| dc.contributor.advisor | Abel Shiferaw | |
| dc.contributor.author | Natnael Gebeyehu | |
| dc.date.accessioned | 2025-03-20T13:55:39Z | |
| dc.date.available | 2025-03-20T13:55:39Z | |
| dc.date.issued | 2024-12-09 | |
| dc.description.abstract | Introduction: Histopathologic examination of colonoscopy biopsies is vital for diagnosing gastrointestinal diseases. Granulomas, focal aggregates of immune cells associated with chronic inflammation, are a key area of study. They can be categorized into foreign body granulomas, which isolate non reactive substances without a T cell response, and immune granulomas, which involve continuous T cell-mediated reactions. Granulomas exhibit various patterns, such as foreign body, epithelioid, xanthogranulomatous, suppurative, and necrotizing types, each indicating different causes. They can result from infections such as TB, non-infectious conditions like Crohn’s disease, drug reactions, inherited disorders, malignancies, or idiopathic conditions. Accurate classification is crucial for effective management, ranging from antimicrobial therapy to immunosuppressive treatment. Despite challenges in granuloma distribution and morphology, histopathology remains essential for diagnosing intestinal granulomatous disease and differentiating between IBD subtypes and other conditions. Objectives The objective of this study is to understand patient’s clinical features and histopathologic distribution of granulomas found in colonoscopy biopsies that guides in early categorization and management selection of patients. Methods: This is a cross sectional descriptive study which will be conducted to describe patients presenting clinical features, distribution pattern on colonoscopy biopsy and histopathologic characteristics of granulomas in those attending the GI outpatient clinic at Tikur Anbessa Specialized hospital (TASH). 9 Result and discussion This study provides a comprehensive analysis of patients diagnosed with Crohn's Disease (CD) and Tuberculosis (TB) at a gastrointestinal clinic over a six-month period. The findings reveal that a significant proportion of the study population was female (64%), with a mean age of 33.5 years. The average age of symptom onset was 30.8 years, indicating that symptoms typically manifest in the late twenties to early thirties. A notable proportion of patients had a history of prior surgery (33.7%) and TB (15.7%). The majority of patients (76.4%) were diagnosed with CD, while 16.9% were diagnosed with TB. Diagnostic methods included colonoscopy (37%) and histopathology (34.5%). Abdominal pain was the most common presenting symptom (68.8%), followed by chronic diarrhea without blood (12.9%) and anorectal pain (10.8%). During follow-up, 21% of cases experienced a change in diagnosis, with 18% reclassified as CD and 2% as TB. Over half of the patients (56%) were hospitalized for their condition. Initial treatment patterns revealed that 47% of patients were started on steroids, 32% on immunomodulators, and 15% on anti-TB treatment. A significant proportion (41.6%) underwent surgery during follow-up. Histologic findings highlighted the presence of increased inflammatory cells and granulomas. Imaging findings, particularly bowel wall thickening and unremarkable ultrasound Results: were significant in differentiating CD from non-CD conditions. | |
| dc.identifier.uri | https://etd.aau.edu.et/handle/123456789/5151 | |
| dc.language.iso | en_US | |
| dc.publisher | Addis Ababa University | |
| dc.subject | Colonoscopy Biopsy | |
| dc.title | Clinical Features and Histopathologic Distribution of Granuloma in Colonoscopy Biopsy | |
| dc.type | Thesis |