Ischaemia

• measurements:

- small bowel segment - length and maximum diameter (cm).

• inspect and describe: hyperaemia/duskiness of the serosa, perforation, constriction bands across the bowel or mesentery.

• open longitudinally with blunt-ended scissors along the mesenteric border - inspect for mucosal thinning, ulceration, haemorrhage, necrosis, perforation, stricture formation, or any underlying tumour that might have precipitated volvulus or intussusception.

• fix by immersion in 10% formalin for 36-48 hours.

• transverse section the proximal and distal limits of resection.

• sample (five blocks minimum) representative macroscopically normal and abnormal areas as indicated (Figure 4.5).

• sample mesentery with constituent vessels (a minimum of two blocks).

• sample mesenteric lymph nodes.

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