The diagnosis of inflammatory bowel disease is often unsupported in clinical practice - Diagnostic criteria are unmet in many suspected IBD cases! Only about half of suspected inflammatory bowel disease (IBD) cases satisfy the necessary prerequisites for the pathologist to make a conclusive diagnosis, with a misleading diagnosis causing improper treatments, as well as ethical and economic consequences. The initial work-up of suspected IBD patients requires the integration of clinical, laboratory, endoscopic, and histological data to avoid misdiagnoses. In this study, only 47.2% of patients had a conclusive diagnosis. Endoscopic findings were available for 77.9% of the histology request forms, yet symptoms, data of onset, and treatments were rarely reported; furthermore endoscopic sampling was deemed inadequate in 87% of the cases, and only 13% of patients received a complete sampling of five sites, including the ileum and the rectum. The likelihood of a conclusive diagnosis was significantly related to the availability of clinical information about the onset of symptoms and treatment. The concurrent description of active inflammation, ulcers, and crypt distortion in the microscopy section of the histology report was correlated with the availability of complete endoscopic sampling and with the occurrence of a specific diagnosis of IBD. The main cause of lack of effective cooperation between clinicians, endoscopists, and pathologists in the diagnostic process is the time consuming and organizational efforts of multidisciplinary teams, although such efforts would be offset by a more effective management of the patient.
Posted on: Sat, 01 Nov 2014 23:09:35 +0000
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