Colonic endoscopy in detecting lower GI lesions and its histologic correlation

Aims and Objectives: The aim of this study was to see the efficacy of endoscopic colonoscopy in detecting lower GI lesions and differentiation on the basis of color and surface pattern findings on colonoscopy with histopathologic correlation. Materials and Methods: 94 patients with the lower GI symptoms were subjected for lower GI endoscopy by Olympus Evis Exera III CLV-190 HD colonoscope for suspected neoplastic and inflammatory lesions. Biopsies were taken from all suspected lesions stained with Haematoxylin and Eosin as well as Periodic Acid Schiff-Diastase stain. Statistical analysis was done to compare the endoscopic diagnosis with the histopathological diagnosis. Results: 70 (74%) were males and 24 (26%) were females, with male to female ratio of 2.9: 1. Majority of the patients were in the third decade of life. CECT whole abdomen showed positive findings of colorectal malignancy in 14 (56.0%) of the total 25 cases. Conventional endoscopic was suggestive of inflammatory colorectal lesion in 59 (62.8%) and neoplastic polypoidal lesion in 35 (36.2%) patients. On histopathological examination, 9 patients were diagnosed with non-neoplastic lesions; of which 6 (66.7%) cases were diagnosed as hyperplastic polyps, 2 (22.2%) as juvenile polyps and 1(11.4%) case as inflammatory polyp. Biopsy of 59 cases of UC showed 39 patients to be mild UC and 20 cases as quiescent UC. The sensitivity and specificity of conventional endoscopic in differentiating between neoplastic and non-neoplastic colorectal lesion was 87.7% and 71.8% respectively and 91.0% and 55.0% respectively in determining the grade of inflammation in ulcerative colitis. Conclusions: Colonic endoscopy is a valuable tool in the diagnosis of bowel diseases, especially bleeding lesions and crohn's disease with high sensitivity and specificity in differentiating between neoplastic and non-neoplastic colorectal lesions.