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The Old Endoscopy Quiz (and Answer) of the Month
April 2007

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Question:

This lady in her upper middle age had suffered from some functional bowel symptoms for years, mainly diarrhea and she had treeted these with an aloe-vera-preparation. This was the finding in her caecal region and ascendens during a colonoscopy. What is this finding?

Correct answer:

Pseudomelanosis coli (also called Melanosis coli)

Typical mucosal pigmentation seen in melanosis coli

Melanosis coli is a pigmentation of the rectal and colonic mucosa due to use (or abuse) of anthraquinone type laxatives. Histologic specimens show numerous macrophages containing a granular dark pigment in the lamina propria. Withdrawal of the offending laxative, which nearly always can be substituted with a bulk laxative, is sufficient treatment.

Correct answers and comments were emailed by

Salvatore Della Ducata, Gallipoli, Italy
Virendra Parikh,MD, Fort Wayne, USA, Indiana
Zahreddine Radwan, Beirut, Lebanon
LUIS GUILLERMO GUERRERO, BOGOTA, COLOMBIA
Ervin Toth, Malmö, Sweden
Ulrike Hurler, Heidenheim, Germany
MONIER Jean-Michel, LYON, FRANCE
MAJID HOSSEINIAN, TEHRAN, IRAN
Dr.Arber Veliu, Prishtina, Kosova
Sharon Hauckwitz, Mooretown, Ontario ,Canada
BURHAN TAM, İSTANBUL, TÜRKİYE
NALAN TAŞIN, İSTANBUL, TÜRKİYE
vitor fernandes, almada, portugal
Peter Moncur, Durham, UK
klaudia jadwia niepsuj, Gliwice, Poland
Ho Dang Quy Dung, Cho Ray Hospital, Ho Chi Minh, Viet Nam
COŞKUN KAYA, AĞRI, TURKEY
ABDELKRIM ZAIBEK, ALGIERS, ALGERIA
Ayyakannu Kumar, Brentwood, United Kingdom
Dr Sheikh Anwarn Abdullah
kaup: Kuala Lumpur Malaysia
PARABOLI SILVA , marcio luiz, Sao Jose do Rio Preto, BRAZIL
Cheryl Lynch, Erie, PA/USA
Ellie Pongratz, Bowie, MD, USA
Antonio Siqueira, Brasilia, Brasil
CELALETTİN ÇETİN, BURSA, TÜRKİYE
MMansour, NYC, USA
dongjun fan, taiyuan, china
Mirhan Tosun, İstanbul, Turkey
ioannis kalliakmanis, athens, greece
rashedhassen, fakous, egypt
Tracy Wood, Darlington, County Durham, UK
Jose Dondis, Panama, Panama

Montral, Canada haissam nourallah, montreal, canada
Ioanna Davidi, Larisa, Greeece
Munir Bishara, Melbourne, Australia
BURHAN TAM, İSTANBUL, TÜRKİYE
HASAN ÇULCU, İSTANBUL, TÜRKİYE
bassam adil ghazalah, al ain, UAE
arsenio co, manila, philippines
José Rojman, Rosario, Argentina
Mehmet Polat, ANKARA, TÜRKİYE
Ma³gorzata Ferenc, Olsztyn, Poland
Thomas Limper, Hilden, Germany
sp, mumbai, india

Comments:

Excellent -and surprising - as the pigmentation in this case was quite mild.

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