LETTER

Finding mucosal tears in collagenous colitis during colonoscopic insufflation

J C Yarze¹

¹ Gastroenterology Associates of Northern New York, Five Irongate Center, Glens Falls, New York 12801, USA; yarze@capital.net

Keywords: inflammatory bowel disease; mucosal tears; endoscopic insufflation

The first 150 words of the full text of this article appear below.

Recently, I had the opportunity to review the interesting retrospective descriptive study of Cruz-Correa et al (Gut 2002;51:600). In brief, the authors described three patients who underwent colonoscopic examination for evaluation of chronic diarrhoea. During the colonoscopic examination, prominent mucosal tears in the ascending and transverse colon regions were noted. Biopsies of macroscopically normal appearing mucosa revealed changes supportive of underlying collagenous colitis. The authors attributed the mucosal tears, and their distribution, to the collagenous colitic process.

I have wondered about another possibility. Although the examinations were performed by experienced endoscopists, could these lesions have been induced by barotrauma? Along these lines, were the lacerations seen as the colonoscope was actually in the ascending colon and insufflation was performed, or were they found "unexpectedly" as the proximal colon was intubated, as has been reported in barotrauma induced colon lacerations.¹ Barotrauma induced colon injury can obviously occur . . . [Full text of this article]

M Cruz-Correa²

² Department of Medicine, Johns Hopkins University School of Medicine, Meyerhoff Digestive Disease IBD Center, Baltimore, Maryland 21287, USA; macruzco@jhsph.edu

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