the Gastrolab Endoscopy Quiz of the Month - Old Quizes and Answers: January 2005

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The Old Endoscopy Quiz (and Answer) of the Month
January 2005

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Question:

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This middle aged lady had surrered from a severe constipation for many years. Defecation was painful and often lasted more than half an hour. The feces were occasionally covered with blood. The colonoscopy was otherwise normal but in the rectum there was an area shown in these images. The mucosa was reddish and easily bleeding after contact with the colonoscope. What is this finding?

Answer:

    A rectal mucosal injury caused by an external rectal prolapse, which was easily demonstrated during the colonoscopy. A lesion like this represent the mildest form of the Solitary Rectal Ulcer Syndrome.


    A solitary rectal ulcer
    		Solitary Rectal Ulcer SyndromeMultiple or single ulcers (and sometimes only mucosal injury without any ulcer) in the distal or middle part of the rectum sometimes resembling a rectal cancer in an endoscopic examination. The cause of this syndrome is thought to be an internal or external rectal prolapse and constipation. The main symtoms are lower abdominal pain and blood in the stools. The treatment is that of treating constipation with bulk laxatives and by avoiding straining during defecation. The prognosis is not always favourable and sometimes a rectal prolapse can be treated surgically.

Answers and comments were emailed by

    Ahmet Faruk Agan, Istanbul, Turkey
    Hurler, Ulrike, Heidenheim, Germany
    Christos Zavos, Thessaloniki, Greece
    Klaudia J.Niepsuj, Bytom, Poland
    German Lloret Salom, Alzira, España
    Ashfaq ahmed, Karachi, Pakistan
    Dr.Virendra Parikh, Fort Wayne, Indiana, USA
    Christian Nielsen, Vasa, Finland
    hisham, Dubai, UAE
    Sami Savela, Jyväskylä, Finland
    PARABOLI SILVA , Marcio Luiz, SAO JOSE DO RIO PRETO, BRAZIL
    LUISGUILLERMOGUERRERO, BOGOTA, COLOMBIA
    Balaz Marian, Schmalkalden, Germany
    Dr.Umut, TURKEY
    DR.Ali BUTURAK, Istanbul, TURKEY


The Pidgeon Rocks, one of the wonders of nature in Beirut

    Zahreddine Radwan, Beirut, Lebanon
    rashedhassen, Fakous, Egypt
    Nuri Ozden, Nashville, USA

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