Home » Volumes » Volume 47 May/June 2014 » Differential diagnosis of ulcers throughout the colon

Differential diagnosis of ulcers throughout the colon

Morakod Deesomsak[1] Wattana Sukeepaisarnjaroen[2] Kittisak Sawanyawisuth[2] [3]

[1]Samitivej Hospital, Bangkok, Thailand [2]Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand [3]Researches and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

DOI: 10.1590/0037-8682-0043-2014

A 61-year-old Bristish woman, had history of visiting Far East for years, presented with abdominal cramping pain and bloody mucous diarrhea for 3 weeks. Examination of her stool showed that it contained white and red blood cells more than 100 cells/mm3 and that her stool culture was negative for enteropathogenic organisms. A colonoscopy was performed to exclude malignancy, ulcerative colitis, or infectious colitis. The colonoscopy revealed the presence of numerous well-circumscribed, oval shaped ulcers, size 0.2-1.0cm spanning the area from her cecum (Figure A) to her rectum (Figure B). Tissue pathology revealed the presence of amebic trophozoites containing digested red blood cells (Figure C). The patient was successfully treated with metronidazole. Diffuse colonic ulcers (Figures A) and (B) may result from several different causes, such as amebiasis, tuberculous colitis, ulcerative colitis, or malignancy. These conditions can be differentiated by performing colonosopic and pathological studies.


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3. Madanagopalan N, Vedachalam SP, Subramaniam R, Murugesan RG. Rectal and colonic mucosal biopsy findings and faeces, sigmoidoscopy, and histopathological correlation in amoebiasis and other colitis. Gut 1968; 9:106-110. [ Links ]

Received: February 22, 2014; Accepted: May 14, 2014

Address to: Dr. Kittisak Sawanyawisuth. Department of Medicine/FM/Khon Kaen University. Khon Kaen, 40002, Thailand. Phone: 66 43363664; Fax: 66 43348399. e-mail: kittisak@kku.ac.th