Bowel (trauma)

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These are specimens removed for hollow viscus perforation. The specimens are frequently received in formalin and feature traumatic stigmata including full-thickness perforations, hematomas, or other defects. They are always received unoriented.

Triage

The role of triage in these specimens is minimal. Open all bowel portions, even if received in formalin. Try not to traverse any existing perforations with your cut when opening the bowel. If received fresh, measure and record the length and internal circumference. Take abundant photographs (fresh or fixed) illustrating all defects in detail (as these might be used for medicolegal purposes).

Gross

  1. Document the presence or absence of defects, and describe number and extent.
  2. Photograph the specimen thoroughly, including any defects, if one is not taken at triage.
  3. Section COMPLETELY THROUGH THE SPECIMEN to evaluate for incidental findings including both mucosal and mesenteric lesions. Document and photograph any unexpected findings.
  4. Take the following sections:
    1. One section of traumatic stigmata (perforation, hematoma, etc). PLEASE ONLY SUBMIT ONE CASSETTE OF EACH “TYPE” OF DEFECT, IRRESPECTIVE OF MULTIFOCALITY.
    2. One section of uninvolved bowel (a representative section from each margin is acceptable).
    3. Any incidental lesions, if identified.
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