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

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

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Question:

So, the autumn is here again. This lady in her middle age had been followed up for an inactive ulcerative proctitis for over 10 years and then she came for her first total colonoscopy during this time. She was quite free of symptoms, as she had been for several years. This is the finding in her caecum. What is this?

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Answer:

Ulcerative Colitis Affecting the Appendix

This combination of a distal ulcerative colitis and affection of the appendix has been recognized for a few year, for example in this abstract:

Matsumoto T, Nakamura S, Shimizu M, Iida M: Significance of appendiceal involvement in patients with ulcerative colitis. Gastrointest Endosc. 2002 Feb;55(2):180-5.

Appendix seems to play an important role in the pathogenesis of ulcerative colitis. Appendicectomy has been found to give a slight protection against this disease. And why not read the following interesting publication:

Mitsunobu Matsushita, Hiroshi Takakuwa, Yuji Matsubayashi, Akiyoshi Nishio, Susumu Ikehara, Kazuichi Okazaki : Appendix is a priming site in the development of ulcerative colitis. World J Gastroenterol 2005 August 21;11(31):4869-4874

This image shows an affected appendix orifice in an other patient with a very similar finding

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