Editor's quiz: GI snapshot
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| The first 150 words of the full text of this article appear below. |
The figure (for question see page 10.1136/gut.2006.110395) showed an ulcer on the dorsum of the left hand with an undermined edge, well defined borders and surrounding erythema. This appearance is characteristic of pyoderma gangrenosum. Pyoderma gangrenosum is an uncommon, ulcerative skin lesion described in association with a variety of systemic conditions. Inflammatory bowel disease is the most commonly detected underlying systemic condition (found in 30% of patients). Crohn’s disease and ulcerative colitis are represented equally.
Figure 1 CT scan showing abscess in the left inguinal region.
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CT scan of the abdomen and pelvis showed a complex inguinal collection (fig 1 below), confirming the clinical impression of below an abscess. Percutaneous drainage yielded pus.
Radio-contrast injection into the abscess cavity opacified the sigmoid colon (fig 2), indicating the presence of a fistulous tract (colo-cutaneous fistula). Colonoscopy showed extensive ulceration in the sigmoid colon and rectum. A diagnosis of fistulising Crohn’s
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Gut 2008 57: 204.[Extract] [Full Text] [PDF]
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