Editor's quiz: GI snapshot

Cobblestone appearance in the colon of a 24-year-old man

T Kobayashi¹, S Shikuwa^1,2, Y Matuoka³, M Ito⁴, H Isomoto², S Kohno²

¹ Departments of Internal Medicine, National Nagasaki Medical Center, Omura, Japan
² Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan
³ Departments of Radiology, National Nagasaki Medical Center, Omura, Japan
⁴ Departments of Pathology, National Nagasaki Medical Center, Omura, Japan

Correspondence to:
Dr Hajime Isomoto, Second Department of Internal Medicine, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan; hajimei2002@yahoo.co.jp

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

CLINICAL PRESENTATION

A 24-year-old man was admitted due to intractable diarrhoea. Physical examination revealed waxy papular skin lesions of the neck and axilla. He had a leukocytosis (10 400/µl) but there were no abnormalities in biochemical and serological data including serum immunoglobulins, anti-nuclear antibody and neutrophil cytoplasmic components. Repeated stool cultures yielded no enteric pathogens. Barium enema showed many polypoid lesions and barium flecks resembling cobblestones in the descending and transverse colon (fig 1), but barium examination of the small bowel and upper alimentary tract showed no abnormality. Histopathological examination of biopsies at colonoscopy (fig 2) showed non-specific chronic inflammation and lymphoid hyperplasia without microgranuloma. Abdominal computed tomography showed thickening of the affected bowel wall without any complications including an abscess and fistula. The patient was treated with mesalamine (1500 mg/day) and total parenteral nutrition for 2 months, leading to cure of his symptoms and remarkable improvement of . . . [Full text of this article]

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

ANSWER
Gut 2008 57: 716. [Extract] [Full Text] [PDF]