Abstract
A 47-year-old Japanese female was referred to our hospital with complaints of chronic diarrhea, bloody stool and lower abdominal pain. Colonoscopic findings of the patient include (1) edematous, friable mucosal appearance and indistinct vascular patterns in the colorectum, (2) patchy erythemas in the ascending colon and (3) mucosal hypertrophy and apthoid ulcers surrounded by small exacavations from the sigmoid colon to rectum. A histologic examination of biopsied colorectal mucosa showed thick collagen band in the limited upper i. e. subepithelial area and chronic inflammatory cell infiltrates in the lamina propria. A diagnosis of collagenous colitis was made by these findings. She has been treated with salazosulf apyridine 1500mg/day per os for five years from her first visit to our hospital. However, her complaints have not been improved and the frequent (6 times) endoscopic examination does not demonstrate any improvement. Although it has been reported that the majority of patients with collagenous colitis have an almost normal colonoscopic appearance, our case showed a unique endoscopic appearance which is worth reporting.
