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Biomedical subjects

B C Morson

Publications and source records attributed to B C Morson.

At least 91 records · Page 5Linked to original sources

Eosinophilic gastroenteritis.

Eosinophilic gastroenteritis is an uncommon condition affecting one or more segments of the gastrointestinal tract, mainly the stomach and small bowell, the principal changes being a variable degree of both oedema and eosinophilic infiltration. Occurring at any age it is commonest in the third decade, is often associated with abdominal pain and peripheral blood eosinophilia, and responds to steroids: allergy or asthma occurs in some 25% of patients. The oedema and eosinophilia involve the submucosa generally but any layer of the gut may be affected. The aetiology is discussed: no allergic or other cause has been determined and it is probable that further knowledge of the role of the eosinophil may be necessary before the precise nature of the lesion can be understood. An association of eosinophilic gastroenteritis with malabsorptive or protein-losing enteropathies is noted.

Adult↗

Inflammatory fibroid polyp of the gastrointestinal tract.

Details of 13 new cases of inflammatory fibroid polyp of the gastrointestinal tract and of 76 patients recorded in the literature (total 89) are described and analysed. The lesion is always benign, may occur at any age but is commonest in the sixth and seventh decades, and involves the stomach most frequently. Abdominal pain, often related to obstruction, is the principal symptom. Eosinophilia of the peripheral blood does not occur. The lesions are sessile or polypoidal, originate in the gut submucosa, vary greatly in cellularity, and have a wide range of tissue eosinophilia. Some are very vascular, many of the larger vessels having a notably broad zone of connective tissue about them. The aetiology of the condition is discussed and reasons for distinguishing it from eosinophilic gastroenteritis, with which it is frequently confused, are given. The precise nature and aetiology of the inflammatory fibroid polyp remains undetermined.

Adult↗

Genetics of gastrointestinal polyposis.

This review deals with the types of gastrointestinal polyposis in which genetic factors play an essential part, namely, the hamartomatous lesions of Peutz-Jeghers syndrome and multiple juvenile polyposis and the neoplastic tumors of familial polyposis coli and multiple adenomas. The mode of inheritance, associated lesions, malignancy potential, and possible interrelationships between the various types of polyposis are discussed. The knowledge that the lesions are inherited should enable other family members to be investigated and treated at an early stage, a matter of considerable importance in the prevention of cancer when there is an associated risk of gastrointestinal carcinoma.

Adenoma↗

The adenoma-carcinoma sequence.

Evidence has been presented to show that most carcinomas of the large bowel develop in an adenoma, and that the life history of this sequence, although variable, probably takes on average 10 to 15 years. However, when the absolute numbers of adenomas and carcinomas are compared, it is apparent that the transition is uncommon. On a statistical analysis the malignant potential of adenomas is related to their size, growth pattern, and degree of epithelial atypia. If the adenoma-carcinoma sequence is the norm, then a study of these criteria in adenomas at different sites in the colon and rectum would resolve the disparity in published series between the distribution of adenomas and carcinomas.

Adenocarcinoma↗

Pathogenesis of diverticulitis complicating granulomatous colitis.

The involement of diverticula by granulomatous colitis may cause an increased incidence of diverticulitis. Of 21 patients with Crohn's disease and associated diverticulosis who underwent resection, sigmoid diverticulitis was pathologically confirmed in 10 (48%). The clinical recognition of the coexistence of the two diseases is often difficult. The radiological signs of peridiverticulitis complicating granulomatous colitis usually show clear evidence of the underlying pathological changes. They include localized diverticular performation, perhaps with multiple communications via a paracolonic sinus tract, mass pressure from the paracolicabscess, and occasionally some degree of communication with deep fissuring ulcers of Crohn's disease. Because diverticula breach the colonic wall, histological analysis confirm that their involvement by the transmural process of granulomatous colitis predisposes to peridiverticulitis and/or abscess formation.

Aged↗

Symposium on colorectal cancer. 1. Pathology of colorectal cancer.

Most colorectal cancers arise from pre-existing adenomas (the adenoma-carcinoma sequence). The histology, cytology and malignant potential of the adenoma group of tumours are described. From a study of the life history of the adenoma-carcinoma sequence in cases of both familial polyposis and isolated adenoma it would appear that most colorectal cancers evolve over a long period. The adenoma is important as a marker for increased risk of colorectal cancer, in clinical practice and in epidemiologic studies. Local excision for carefully selected early colorectal cancers is justified on the basis of the results of a long-term prospective study.

Adenoma↗

Policy of local excision for early cancer of the colorectum.

A policy of local excision or total biopsy for early cancer of the colorectum, when this is technically possible, has been described. This is based on thorough histological examination of the excised specimen with special reference to the completeness of surgical excision, the depth of spread of the cancer into the bowel wall, and the histological grade of malignancy. The results of this policy in 119 patients treated by local excision only have been studied. There have been 10 recurrences but only five of these are regarded as policy failures. Because of these good results it is suggested that the policy as described should be regarded as an established alternative to partial colectomy, anterior resection, and abdominoperineal excision in carefully selected patients.

Adult↗

Cancer in colitis: assessment of the individual risk by clinical and histological criteria.

The cancer risk among 229 patients with extensive ulcerative colitis observed during January 1, 1966 to February 29, 1976 is correlated with the length of history and the histological findings in rectal and colonic biopsies. Five patients are known to have developed carcinoma. No carcinoma was observed in 578 patient years of follow-up within 10 years of onset of the colitis, but the risk in the second decade was approximately 1 in 200 patient years and in the third, 1 in 60 patient years. Severe epithelial dysplasia was rare and found in 32 biopsies from 13 patients. No carcinoma has occurred during the period of follow-up in patients without dysplasia. It has not been possible to follow the development of dysplasia in sequential biopsies. Seven patients with consistent severe dysplasia on biopsy have been treated surgically; carcinoma confined to the bowel wall (Dukes' A) was found in 4. A scheme of management for patients with extensive colitis, including regular rectal and colonic biopsies, is proposed. Our results suggest that such a program will isolate a small group of patients who require surgical treatment for established precancerous change or carcinoma with a high likelihood of cure.

Biopsy↗

Faecal bile-acids and clostridia in patients with cancer of the large bowel.

Of 44 patients with cancer of the large bowel, 36 ( 82%) had high faecal bile-acid concentrations compared with only 15 (17%) out of 90 patients with other diseases. 31 (70%) of the 44 patients with large-bowel cancer had high faecal bile-acid concentrations in the presence of faecal clostridia able to dehydrogenate the bile-acid nucleus, compared with only 8 (9%) out of 90 patients with other diseases. Thes findings support the hypothesis that cancer of the large bowel is caused by high concentrations of bile-acid derivatives produced by certain anaerobic bacteria.

Adult↗