RSS-Feed abonnieren
DOI: 10.1055/s-2007-966652
© Georg Thieme Verlag KG Stuttgart · New York
Hydrogen peroxide-related colitis (previously known as ”pseudolipomatosis“): a series of cases occurring in an epidemic pattern
Publikationsverlauf
submitted 29 April 2007
accepted after revision 7 May 2007
Publikationsdatum:
02. August 2007 (online)
![](https://www.thieme-connect.de/media/endoscopy/200710/lookinside/thumbnails/10.1055-s-2007-966652-1.jpg)
We report several cases of hydrogen peroxide-related colitis that occurred in an epidemic pattern in our gastrointestinal endoscopy center during a 2-month period in early 2007. During colonscopy using sterilized endoscopes that had been flushed with hydrogen peroxide after the peracetic acid cycle, instantaneous effervescence and blanching (the ”snow white sign“) were observed on the intestinal mucosa when the water button was depressed. Biopsy specimens revealed features resembling a clinical condition which used to be known as ”pseudolipomatosis.“ At follow-up, no patient was found to have suffered morbidity associated with this peroxide colitis. Endoscopists should consider hydrogen peroxide colitis when they see a snow white sign during colonoscopy which cannot be attributed to active inflammation or organic disease of the digestive tract.
References
- 1 Snover D C, Sandstad J, Hutton S. Mucosal pseudolipomatosis of the colon. Am J Clin Pathol. 1985; 84 575-580
- 2 Brevet M, Chatelain D, Bartoli E. et al . Colonic pseudolipomatosis: clinical, endoscopical and pathological features in nine cases. Gastroenterol Clin Biol. 2006; 30 9-16
- 3 Lapeyre B. The ”frost sign” and the ”snow white sign”: intramucosal air injection or peroxide colitis?. Endoscopy. 2005; 37 679
- 4 Bilotta J J, Waye J D. Hydrogen peroxide enteritis: the ”snow white” sign. Gastrointest Endosc. 1989; 35 428-430
- 5 Ben Rejeb A, Khedhiri F. Mucosal pseudolipomatosis of the colon: apropos of a case with a review of the literature. Arch Anat Cytol Pathol. 1989; 37 254-257
- 6 Waring J P, Manne R K, Wadas D D. et al . Mucosal pseudolipomatosis: an air pressure-related colonoscopy complication. Gastrointest Endosc. 1989; 35 93-94
- 7 Jonas G, Mahonas A, Murray J. et al . Chemical colitis due to endoscope cleaning solutions: a mimic of pseudomembranous colitis. Gastroenterology. 1988; 95 1403-1408
- 8 Ryan C K, Potter G D. Disinfectant colitis: rinse as well as you wash. J Clin Gastroenterol. 1995; 21 6-9
- 9 Meyer C T, Brand M, de Luca V A. et al . Hydrogen peroxide colitis: a report of three patients. J Clin Gastroenterol. 1981; 3 31-35
- 10 Coton T, Bohand X, Guisset M. et al . Acute colitis induced by a peracetic acid-based solution used to disinfect endoscopes. Gastroenterol Clin Biol. 2003; 27 556-558
G. Cammarota, MD
Istituto di Medicina Interna
Policlinico Universitario ”A. Gemelli”
Largo A. Gemelli 8
Rome 00168
Italy
Fax: +39-06-35502775
eMail: gcammarota@rm.unicatt.it