Subscribe to RSS
DOI: 10.1055/s-0029-1214624
© Georg Thieme Verlag KG Stuttgart · New York
New endoscopic images of mucosal prolapse syndrome
Publication History
Publication Date:
19 June 2009 (online)
A 65-year-old man presented with hematochezia and fecal incontinence. For a long time he had been experiencing severe constipation and had needed to train to evacuate the bowels. Conventional colonoscopy revealed a hyperemic broad-based polypoid lesion with central ulceration in the lower rectum ([Fig. 1]). Magnifying colonoscopy with narrow-band image system (NBI) revealed dilated brownish, oval-to-long pits and widening of the pericryptal space around the polypoid lesion ([Fig. 2]). There was no destruction of or irregularity in the pit pattern and no abnormalities in the microvessels. Autofluorescence imaging (AFI) revealed a magenta-colored elevation surrounding the yellowish-green ulcerated area ([Fig. 3]). Histological examination of biopsy specimens taken from the polypoid lesion revealed elongation and distortion of the crypts and fibromuscular obliteration in the mucosa ([Fig. 4]). On the basis of the clinicopathological features, a diagnosis of mucosal prolapse syndrome was made. The patient was successfully treated with bowel retraining to avoid straining at defecation and dependence on laxatives.
Fig. 1 Colonoscopy showing a polypoid lesion with central ulceration in the lower rectum of a patient with bleeding per rectum and fecal incontinence.
Fig. 2 Dilated, brownish pits and widened pericryptal space in the region of the lesion visualized on magnifying colonoscopy.
Fig. 3 Autofluorescence imaging (AFI) findings: a magenta-colored elevation surrounds the yellowish-green ulcerated area.
Fig. 4 Microscopic examination shows elongation and distortion of the crypts and fibromuscular obliteration in the mucosa.
Endoscopy_UCTN_Code_CCL_1AD_2AJ
C. C. Chen, MD,
H. Isomoto, MD
Second Department of Internal Medicine
Nagasaki
University School of Medicine
1-7-1 Sakamoto
Nagasaki
852–8501
Japan
Fax: +81-95-8497285
Email: cszen@hotmail.com
Email: hajimei2002@yahoo.co.jp