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The Old Endoscopy Quiz (and Answer) of the Month
March 2006

the GASTROLAB Home Page
the Quiz Page

Question:

And so the days are getting lighter as the sun is rising here in the North of Europe. This young man came to a colonoscopy as he had suffered from bloodstained diarrhea for several months. These images show the findings in his rectal and sigmoidal area. He clearly has a chronic inflammatory bowel disease, but it is not always easy to differentiate between ulcerative colitis and Crohn. So, this is more of an opinion poll than a quiz. What would You consider this disase to be, ulcerative colitis, Crohn colitis, indeterminate colitis - or something else?

Answer:

    Ulcerative Colitis.

    The longitudinal ulcers in the rectum resemble Crohns disease, but they are quite superficial and a finding like this is not rare in a patient with ulcerative colitis.

    And here are the votes:

      Ulcerative colitis
      Crohns colitis
      Pseuomembranous enterocolitis
      Inflammatory bowel disease
      Sexually transmitted infection
             		29
      16
      2
      1
      1
    And of course - nothing is 100% certain in medicine. If the diagnose change during the follow up of this patient, the we will make a note of that in this page.

Answers, comments and votes were emailed by

    German Lloret Salom, Alzira, Spain
    Salvatore Della Ducata, Gallipoli, Italy
    Linda Clark, New Glasgow, Canada
    PARABOLI SILVA , Marcio Luiz, SAO JOSE DO RIO PRETO-SP-, BRAZIL
    H.D. Quy Dung, CR Hospital, Ho Chi Minh, Viet Nam
    isil Manisa, Turkey
    Faruk Erebrie Granados, Medellin Colombia
    mihai rimbas, bBucharest, Romania
    Manimaran, Stafford, United Kingdom
    JANET KENT, BARNSLEY, ENGLAND
    nsatish, Pondicherry, India
    Ellie Pongratz, Bowie, MD
    melissa, powdersprings, ga
    Klaudia J.Niepsuj, Gliwice, Poland
    CortStorm, Monster, The Netherlands
    Dr.Virendra Parikh, Fort Wayne, USA, Indiana
    fahri akyuz, Izmit, Turkey
    francesco di stefano, sant'agata li battiati, Italy
    lorna kirkham, milton keynes, UK
    Zahreddine Radwan, Beirut, Lebanon
    IRVIN GABOUREL, BELIZE, BELIZE
    Radu Ionescu, Bucharest, Romania
    Yaşar Nazlıgül, Ankara, TÜRKİYE
    Dr.Arber Veliu, Prishtina, Kosovo
    rashedhassen, fakous, Egypt
    Zeynel Mungan, Istanbul, Turkey
    Mohan Persaud, MD, West Palm Beach, USA/Florida
    c.harlaar, Winterswijk, the Netherlands
    deepak, Stornoway, UK/western isles
    Hakjung Kang, Seoul, South Korea
    muhammad iqbal, Rawalpindi, Pakistan
    atef hayes, sherbin, Egypt
    Dr Wissam Chalhoub, Beirut, Lebanon
    Hiam Mustafa E. Mohammed, Khartoum, Sudan
    Claudia Iacobescu, Bucharest, Romania
    xiaohong liao, Jingzhou, China
    fahri akyüz, Kocaeli, Turkey
    Amy, Tacoma, Washington, USA
    Ho Dang Quy Dung, Ho Chi Minh, Viet Nam
    Wassim A Khalek, Alicante, Spain
    KHALID AHMED BAMAKHRAMA, DUBAI, UAE
    Dr.khalid ahmed bamakhrama, DUBAI, UAE
    Chen lihua, Hangzhou, People's Republic of China
    Katarina Lesnovska, Linköping, Sweden
    Jack Chen, Miaoli, Taiwan
    SERDAR GUL, ISTANBUL, TURKEY
    U Cuartas, Augusta, USA
    jose dondis, Panama, Panama
    Azzarok Ahmied, Lengerich, Germany, Westfallen
    Fabian Rieber, Tuebingen, Germany

Comments:

    Ulcerative colitis is more fit for this endoscopic images end story of complaints.

    Ulcerative colitis but you need to r/o pseudomembranoous colitis.

    It is possible to ulcerative colitis as the inflammation muster continuous, may be with bacterial superinfection.differential diagnostic should the bacterial induced colitis e.g. clostridium difficil infection with pseudomembranous colitis or salmonellen colitis be considered. stool for cultur and examination recommended.

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