1. A single random biopsy specimen of pouch mucosa is of limited value in assessing pathological changes and screening for potential neoplastic change within the reservoir. 2. The formation of a pelvic ileal reservoir results in pathological changes in the ileal mucosa in most patients regardless of the initial diagnosis. 3. While focality of pathological changes has been observed, very little is known about the distribution of inflammatory and metaplastic changes in the reservoir and the proximal limb. 4. It seems likely that it is the ratio of anaerobes to pathogenic aerobic bacteria that determines the magnitude of pathological change in the established reservoir. 5. These findings are supported by serial observation of reservoirs showing that the mucosa reaches a relatively steady state in terms of pathological changes soon after ileostomy reversal. 6. Several divergent but characteristic pathological changes have been previously shown within the pouch mucosa. 7. The pathological changes of mucosal prolapse deserve particular mention. 8. With rapid improvements in the spatial resolution of MRI systems, its greater sensitivity to pathological change in cerebral tissue has become apparent. |
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