Test your diagnostic skills with the following endoscopic quiz.
Answers are on page 2.
This 47-year-old man underwent surveillance colonoscopy for a history of an adenomatous polyp. He has a history of hemorrhoids and occasional bright red blood on the toilet tissue. There is no history of diarrhea, constipation, or abdominal pain.
His past medical history is positive for hypertriglyceridemia on medical therapy. He is on no other medications regularly.
He does not smoke or use alcohol excessively. Family history is positive for pancreatic cancer in a sister.
Physical examination was unremarkable. Lab tests have been normal.
The photographs are taken from the transverse colon during colonoscopy.
1) The photographs demonstrate:
b) Ischemic colitis
c) An apple core lesion
d) Melanosis coli
e) Pneumatosis intestinalis
2) This condition can be associated with:
a) Bowel necrosis
b) Increased intraluminal pressure
c) Decreased immunity
d) Chronic pulmonary disease
e) All of the above
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Pear BL: Pneumatosis intestinalis: A review. Radiology 207:13-19, 1998.
Rennenberg RJ, Koek GH, Van Hootegem P, et al: Pneumatosis cystoides intestinalis, four cases of a rare disease. Neth J Med 60(1):22-25, 2002.
St Peter SD, Abbas MA, Kelly KA: The spectrum of pneumatosis intestinalis. Arch Surg 138:68-75, 2003.