Editor's quiz: GI snapshot
An unexpected cause of chronic diarrhoea
1 Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
2 Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan
3 Department of Pathology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
4 Department of Emergency Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
Correspondence to:
Dr H-P Wang, Department of Emergency Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Chung-Shan South Road, Taipei 100, Taiwan; whp@ha.mc.ntu.edu.tw
| The first 150 words of the full text of this article appear below. |
CLINICAL PRESENTATION
A 41-year-old man suffered from chronic diarrhoea of 3 years’ duration, accompanied by weight loss of 20 kg. He was referred to our hospital for double-balloon enteroscopy (DBE). On arrival, the laboratory findings were as follows: haemoglobin 10.4 g/dl (normal range 12.0–16.0 g/dl) and albumin 2.9 g/dl (normal range 3.5–5.3 g/dl). DBE was performed via the oral route and reached the middle jejunum. Several irregularly shaped ulcerations, up to 1 cm in size, were found at the gastric antrum and duodenum. Moreover, the jejunal mucosa appeared diffusely whitish, streaky and granular, resembling the texture of marble (fig 1A,B). Severe atrophy of the normal intestinal villi was also noted.
Figure 1 (A) Marbled appearance of the "white small intestine" with diffuse polypoid lesions at the jejunum. (B) In a closer view, atrophy of the villi and diffuse whitish streaks on the lesions were noted.
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QUESTION
What is your diagnosis?
See page 921
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ANSWER
Gut 2008 57: 921.[Extract] [Full Text] [PDF]
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