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And then the last case this summer. This old lady came to a colonoscopy as she was found to have iron deficiency anaemia. She had not experienced any stomach trouble nor had she seen any blood in her stools. These images shows the upper part of the rectum. Two questions this time, one for the beginners and one for the more experienced endoscopists:
* Question for the beginners:
What is the finding in the first image and in the upper part of the second and third image?
* Question for the more experienced endoscopists:
What is the mucosal whitish discolouration seen in the lower part of the second and third image and in the fourth image?
So, just pick one of the questions and send Your answer! And enjoy the summer weeks we have ahead of us!
Chicken skin mucosa is frequently seen adjacent to a colorectal cancer or adenoma. First described by Shatz BA et al, they are called Chicken Skin Mucosa (CMS), and are supposed to occur as a result of fat accumulation in macrophages in the lamina propria adjacent to colonic neoplasms. In a series of 852 consecutive colonoscopies CMS was found adjacent to eight of 10 distal colorectal cancers, one of four of proximal colon cancers and 16 of 42 distal adenomas.

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