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Editor's quiz: GI snapshot
An 80-year-old man with caecal ulceration
  1. Benjamin Easton White,
  2. Adnan Al-Badri,
  3. John Nicholas Gordon
  1. Gastroenterology, Royal Hampshire County Hospital, Hampshire Hospitals NHS Foundation Trust, Winchester, UK
  1. Correspondence to Dr Benjamin Easton White, Gastroenterology, Royal Hampshire County Hospital, Hampshire Hospitals NHS Foundation Trust, Winchester SO22 5DG, UK; benjaminwhite{at}doctors.org.uk

https://doi.org/10.1136/gutjnl-2019-319414

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    Clinical presentation

    An 80-year-old man presented with a 3-month history of altered bowel habit, intermittent right iliac fossa abdominal discomfort and fluctuating perianal pain. He had a background of ischaemic heart disease and was taking atorvastatin, clopidogrel, bisoprolol, isosorbide mononitrate, fenofibrate, nicorandil and furosemide. Abdominal examination was unremarkable with rectal examination revealing a minor posterior fissure. He had a normochromic, normocytic anaemia of 108 g/L and a C-reactive protein of 5. Other bloods were normal.

    A colonoscopy was arranged, which revealed a large area of deep ulceration in the ascending colon extending to the …

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    Footnotes

    • Contributors BEW wrote the case report. AA-B advised on histology and provided histology pictures. JNG provided intellectual content and critically revised the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.