Large bowel strictures – a histopathological review

Stricture of the large bowel develops as complication of numerous disorders. Our aim is to study prevalence, etiologies, incidence in both sex and different age and histological patterns of various large bowel strictures and also to compare with other relevant studies. Large bowel stricture is common in 3^rd to 5^th decades. However, in 3rd decade, inflammatory bowel disease, predominantly tuberculosis, is common lesion, while in later age, malignancy is common lesion.

Tuberculosis, followed by adenocarcinoma is the most common cause of large bowel stricture in our community. Tuberculous strictures of large bowel are more common in female than in male. Adenocarcinoma of colorectum causing large bowel strictures is slightly more common in male and adenocarcinoma with mucinous differentiation is even more common in male.

Caecum is most common site for tuberculous stricture of large bowel. Ratio of adenocarcinoma of Rt. colon to left colon is 1: 1.6. Epithelioid cell granuloma, langhan's type giant cell and caseous necrosis are constant features of tuberculosis. In 55% cases of tuberculous strictures of large bowel, the lymph nodes were involved in tuberculous inflammation.

60% of all adenocarcinoma causing large bowel stricture are mucin secreting. In 46% adenocarcinoma, papillary pattern is seen. Lymph nodes are involved in 33.3% cases.