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

the GASTROLAB Home Page
the Quiz Page

Question:

Click on an image to get a magnification!

These images show the descending part of the duodenum in an old man who came to an upper endoscopy because of atypical chest pain. This finding is not an unusual one and we were convinced that it had nothing to do with the actual symptoms. These small white areas, in the upper part of the first image, in the lower part of the second image and to the left in the other images, what are they, and should anything be done about them?

Answer:

    Duodenal Xanthelasm.

    This is an innocent finding, probably most often not mentioned in the endoscopy report. Xanthelasmas do not cause any symptoms and no treatment is needed.

    This diagnose has been challenged by Gustavo Pignaton in Brasil, and he is probably quite right:

    "Congratulations on your site (gastrolab), your effort to create this page is amazing. I have been reviewing all the images with the purpose of studying for life and improving my knowledge to help in my daily practice. Almost all the pictures have a good quality. I have stumbleb across the images from november 2005, the diagnosis writen there does not match with the real lesion. The correct lesion is lymphangiectatic cyst. Forgive me for this kind of message, but I just could not stop myself.

    Gustavo Pignaton - Rio de Janeiro - Brasil"

    Here is another typical finding:

Answers and comments were emailed by

    There came a lot of answers, all correct.
    Then on November 20th, the hard disc crasched. It was usuallu backed up once a month, on the first day. so, all the answers were lost.
    This might be the most important lesson of this months quiz. We learn, but slowly sometimes. Now we back up our files once a week.
    After that days we got some answers:


    Colosseum, Rome

    Erika, Roma, Italy
    Daud, Roma, Italy
    Jose Ramirez Palanca, Xativa (Valencia), Spain
    Klaudia Jadwiga Niepsuj, Gliwice, Poland
    Dr Ahmed noaman, Cairo, Egypt
    Dr.Jaber Badran, DAIR AZZOR, SYRIA

Comments:

    Xantomas (cholesterol deposits). It's a casual finding. We should do nothing.

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