2013 Volume 55 Issue 6 Pages 1842-1847
An 86-year-old female who had been taking lansoprazole treatment for gastro-esophageal reflux disease was admitted to our hospital with a history of sudden onset of periumbilical pain followed by diarrhea and hematochezia. Colonoscopy revealed a mucosal tear in the descending colon near the splenic flexure, and a longitudinal ulcer associated with blood adhesion in the distal descending colon. Colonic mucosal biopsy revealed thickening of the subepithelial collagen bands and chronic inflammation in the lamina propria, consistent with the typical pathological features of collagenous colitis. The symptoms resolved soon after the lansoprazole treatment was withdrawn. Colonoscopy performed 6 months later revealed scar formation both at the site of the mucosal tear and the longitudinal ulcer, and microscopic examination of biopsy specimens showed disappearance of the collagen bands. Although cases of collagenous colitis usually manifest with chronic watery diarrhea, the case presented herein developed acute abdominal pain and bloody stools, similar to features of ischemic colitis.
