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

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Question:

Click on the image above to start the slide show!

This man in his upper middle age hade been slightly anaemic of the megaloblastic type for several years. His vitamin B12-value was low, so he was thought to have pernicious anaemia. No other blood tests were done. He came to an upper endoscopy in order to get a verification of this diagnose. This is the endoscopic findings, showing images from the oesophagus, cardia, stomach, duodenal bulb and descending duodenum. The pH from his gastric juice was 2. So, what is the cause of his anaemia?

Correct answer:

The cause of his anaemia was Coeliac Disease with the typical mucosal finding in the descending duodenum. He had an acid stomach, practically excluding the possibility of pernicious anaemia.

Here are some more images from the descending part of the duodenum in patients with coeliac disease:

Endoscopic finding in the descending part of the duodenum in coeliac disease

Endoscopic finding in the descending part of the duodenum in coeliac disease

Endoscopic finding in the descending part of the duodenum in coeliac disease

Endoscopic finding in the descending part of the duodenum in coeliac disease

Endoscopic finding in the descending part of the duodenum in coeliac disease

Endoscopic finding in the descending part of the duodenum in coeliac disease

Correct answers and comments were emailed by

yusuf yücel, karabük, Türkiye
Christos Zavos, Thessaloniki, Greece
Aissaoui Lotfi, ARAR, KSA
Lazuchiewicz-Kot Malgorzata, Lodz, Poland
SHARON HAUCKWITZ, MOORETOWN,ONTARIO, CANADA
Claudia Iacobescu, Bucharest, Romania
Cevale Karslioglu Sgouros, Istanbul, Turkey
m.lerios, nicosia, cyprus
rashedhassen, fakous, egypt
Marcel Cina, Presov, Slovakia
MAJID HOSSEINIAN, TEHRAN, IRAN
Ayyakannu Kumar, Brentwood, United Kingdom
Zahreddine Radwan, Beirut, Lebanon
christina, campinas, Brasil
Dr.RADHAKRISHNAN, SHARJAH, U.A.E
Antonio Siqueiira, Brasilia, Brazil
M Pitchaimuthu, Londonderry, UK


Wooden crucifix nicely decorated in front of an orthodox church in Romania. © BALAS MARIA, Cluj Napoca, ROMANIA
dimitris policos, grevena, greece
SevEriN, Heidelberg, Germany
Hurler,Ulrike, Heidenheim, Germany
Phillip Lerner, Seminole, FL USA
RASSIAT emmanuel, Dijon, France
Vanderlei Corradini Simões de Lima, São Sebastião do Paraiso, Brasil MG
samyra lacerda david vargas, Montes Claros, Brasil -MG
Marcel Cina, Presov, Slovakia
amrani khalil, Constantine, Algeria
Fernando Peres, Rio de Janeiro, Brazil
Ervin Toth, Malmö, SWEDEN

Comments:

This months question was not easy. So, Congratulations to You all!

The Best Image Library in the World! That is what we would like Gastrolab Image Library and Endoscopic Archives to be. Perhaps We can achieve this together? Many of You have ecxellent endoscopic images just waiting for publication. When published they can be an invaluable resource for young endoscopists and for gastroenterologic education. Images published here can freely be used for noncommercial purposes. So, please email Your images here glabinfo@gmail.com together with a short caption, a notice that our site is permitted to publish them and information if You want a copyright sign © together with You email address (in which case possible commercial publishers can contact You to get permission to publish Your images). Together we can make the best and most complete Image Library in the World!