A dramatic finding at colonoscopy: cause for concern?

Case report

Benjamin Crooks, Fotios Sampaziotis, Emma Purkis, et al.

Correspondence to Dr Benjamin Crooks, Gastroenterology Department, Watford General Hospital, Vicarage Road, Watford, Herts WD18 0HB, UK; crooks.benjamin@gmail.com

[EXCERPTS]

A 66-year-old woman with a background of diverticular disease, hypertension, chronic kidney disease and amaurosis fugax was referred to our unit for colonoscopy as part of the bowel cancer screening programme following a positive faecal occult blood result.

The colonoscopy was performed following bowel preparation with Moviprep and under sedation with Midazolam 1.5 mg and Pethidine 25 mg. The procedure was straightforward using carbon dioxide for insufflation. Upon examination of the ascending colon several bright red linear lesions with some extravasation of fresh blood were noted. These lesions were visualised in a new segment of ascending colon that had not previously been traversed by the colonoscope. Several biopsies were taken from the site of these markings and sent for histopathological examination. All biopsies were reported as normal. The rest of the colon was otherwise normal and the caecum was easily reached. The patient was well following the procedure with minimal discomfort during and after the examination.

Questions

1. The photograph taken at colonoscopy is shown below. What is the term used to describe this appearance of the colonic mucosa when viewed at colonoscopy?

2. What is the pathological significance of this finding?

 

Case report

Benjamin Crooks, Fotios Sampaziotis, Emma Purkis, et al.

Correspondence to Dr Benjamin Crooks, Gastroenterology Department, Watford General Hospital, Vicarage Road, Watford, Herts WD18 0HB, UK; crooks.benjamin@gmail.com

[EXCERPTS]

A 66-year-old woman with a background of diverticular disease, hypertension, chronic kidney disease and amaurosis fugax was referred to our unit for colonoscopy as part of the bowel cancer screening programme following a positive faecal occult blood result.

The colonoscopy was performed following bowel preparation with Moviprep and under sedation with Midazolam 1.5 mg and Pethidine 25 mg. The procedure was straightforward using carbon dioxide for insufflation. Upon examination of the ascending colon several bright red linear lesions with some extravasation of fresh blood were noted. These lesions were visualised in a new segment of ascending colon that had not previously been traversed by the colonoscope. Several biopsies were taken from the site of these markings and sent for histopathological examination. All biopsies were reported as normal. The rest of the colon was otherwise normal and the caecum was easily reached. The patient was well following the procedure with minimal discomfort during and after the examination.

Questions

1. The photograph taken at colonoscopy is shown below. What is the term used to describe this appearance of the colonic mucosa when viewed at colonoscopy?

2. What is the pathological significance of this finding?

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