• inflammatory bowel disease
• mucosal tears
• endoscopic insufflation

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 …