A rare cause of long-segment colitis

Abstract

A 65-year-old previously well man presented with 3 weeks of generalised abdominal pain and diarrhoea up to three times per day after overseas travel. White cell count (9.6×106/L) and C-reactive protein (196 mg/L) were raised; however, comprehensive stool testing was negative for viral, bacterial and parasitic causes. Faecal calprotectin was <5 µg/g. CT demonstrated a long segment of circumferential bowel wall thickening and oedema from the rectosigmoid to the splenic flexure with normal enhancement of the mesenteric arteries (figure 1). Figure 1 Radiological, endoscopic and histological findings. (A) CT showing diffusely thickened rectosigmoid and descending colon with associated mesenteric stranding. (B) Endoscopic view of the sigmoid colon with pale, oedematous and friable mucosa with telangiectasia. (C) The histology showed marked myointimal hyperplasia of the submucosal veins. The lack of an internal elastic lamina …