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Author: Mikael Häggström [notes 1]

This article also includes the rectum.


Gross processing

More specific grossing is available for presentations above. For larger specimens (not biopsies):

  • Identify segment of colon
  • Measure length and variations in width
  • Inspect the serosa- look for any perforations, adhesions, fistulas and exudate
  • If perforation is present, try to probe it from the serosal surface
  • Open longitudinally
  • Semi-quantitate the number of diverticula – “numerous” if too many to count
  • Look for for any mucosal lesions. Note any evidence of inflammation, hemorrhage, abscess, perforation or fistula
  • Note the thickness of the wall
  • Optionally, measure the mesentery
  • Note any obvious mesenterial lymph nodes
  • Sections to submit for microscopy:
  • 2 sections of any perforation(s), one section of intact diverticulum, any mucosal lesions, any obvious lymph nodes.
  • If there is no perforation: 3 sections of diverticulum.

Microscopic evaluation


In a general screening, look for:

  • Colitis, such as by neutrophilic infiltration

Common incidental findings

Microscopy report

Example report in an unremarkable biopsy:

Colonic mucosa, negative for significant histopathologic changes.


  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

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