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Colorectal Case 25

Dr. Shiaw-Hooi Ho

Associate Professor of Medicine at the Department of Medicine, 

Universiti Malaya, Malaysia

 

Procedure Information

Scope: PCF-H190DL

Case Findings: Crohn’s Ileo-colitis

Organ: Terminal ileum & colon

Patient information: 25 years old, Female

Medical history: Chronic diarrhea for about 1 ½ years prior to consultation; no background medical illness in the past

1. WLI Observation
Discontinuous deep longitudinal ulcers were seen throughout the colon under WLI observation

2. WLI Observation
Some of these ulcers were deep and exposed the underlying muscularis propria layer

3. WLI Observation
Similar discontinuous ulcerations were seen in terminal ileum as well

4. TXI Observation
Under TXI observation, the color and surface of the terminal ileal ulcer were enhanced.

5. NBI Observation
Under NB examination, the villi in the terminal ileum were clearly displayed.

6. WLI Observation
In other part of the colon, similar aphthous ulcers arranged in longitudinal fashion with normal intervening mucosa (skip lesions) were seen throughout the colon.

7. TXI Observation
TXI observation enhanced the color and texture of these aphthous ulcers

8. NBI Observation
Under NBI observation, the surrounding normal mucosa displayed the normal honey-comb mesh capillary pattern

9. NBI Observation

Similar explanation as Picture 8

10. WLI Observation
Another deep longitudinal ulcer was seen under WLI

11. TXI Observation
TXI observation enhanced the appearance of the deep ulcer. The underlying circular muscle could be clearly seen at the ulcer base.

12. NBI Observation
NBI observation revealed the absent of the normal colonic mucosal pattern over the ulcer base.

Case Video

Overall Comment

This young female patient presented with chronic diarrhea for 1 ½ years prior to her consultation in this hospital. The endoscopic findings were classical of typical Crohn’s ileo-colitis: deep longitudinal ulcer with skip lesions and cobblestone appearance. She was started on steroid, azathioprine and was planned for biologic therapy.

* Specifications, design and accessories are subject to change without any notice or obligation on the part of the manufacturer

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