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The Old Endoscopy Quiz (and Answer) of the Month
May 1999

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Question:

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This 65-year old lady had some stomach trouble - sometimes obstipation, sometimes a slight diarrhea and some stomach pain. A colonoscopy was made, and here is the findings. The two first pictures show the caecum, and the third picture the transversum. The mucosa in the caecum is darker than in the transversum. What is the pigmentation seen in the first two pictures?

Answer:

Melanosis (or pseudomelanosis) coli, due to the use of laxatives. The pigmentation usually affects all the colon, sometimes only the caecal and rectal region is affected.

Correct answers were emailed by:

San Diego D.A.Wolochow, MD, San Diego, CA, U.S.A
Curt Tysk, Orebro, Sweden
MARCIO LUIZ PARABOLI SILVA, CAMPO MOURAO -PR, PARANA -BRAZIL
Lars G Salde, Lund, Sweden
Rogério Godinho, Barreiro, Portugal
Kathy Riggs, Abernathy, Texas, USA
Y S Kim, Kangneung, South Korea, Kang Won Do
Peeter Kõiva, Rakvere, Estonia
Josep Roure, Girona, Spain
Greger Lindberg, Stockholm, Sweden
Jeanne Mitchell, Spanaway, Washington, USA
Antti Oksanen, Huddinge, Sweden
Antonio Sia, Patrocinio (MG), Brazil

Comments:

"Melanosis coli"-- an interesting sidelight is that polyps aren't affected, and thus stand out in dramatic contrast to the darker surrounding mucosa.

PSEUDOMELANOSIS COLI is caused by accumulation of a brownish-black lipofuscin pigment iin the lysosomes of the subepithelial macrophages, resulting from the ingestion of anthraquinone laxatives.

Jo Hans, inte vet jag vad detta är men jag tror att jag sett något liknande som dock var mer uttalatoch det var en inlagring av brunt pigment vid ceroidos eller brown bowel syndrome, men det kan nog vara annat pigment också.

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