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首页> 外文期刊>Clinics and research in hepatology and gastroenterology. >High-quality endoscopic perspective on pseudomelanosis ilei: underwater, magnified and image-enhanced
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High-quality endoscopic perspective on pseudomelanosis ilei: underwater, magnified and image-enhanced

机译：High-quality endoscopic perspective on pseudomelanosis ilei: underwater, magnified and image-enhanced

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摘要

A 26-year-old male patient was admitted due to a flare of previously diagnosed ulcerative colitis (UC). After exclusion of superimposed infection, the patient underwent ileocolonoscopy revealing severe left-sided UC (Mayo Endoscopic Score 3), and treatment with systemic steroids was started. Intriguingly, the terminal ileum mucosa exhibited a diffusely speckled appearance on conventional white light endoscopy (Fig. 1A). Water jet cleansing was applied to clear residual bile staining and provide underwater conditions translating into a much more plastic endoscopic visualization of spotty, presumed pigment depositions (Fig. 1B). In addition, ad hoc endoscopic diagnosis of pseudomelanosis ilei was further substantiated by magnified image-enhanced endoscopy, using linked colour imaging (LCI) with moderate (Fig. 1C) and blue laser imaging (BLI) at highest magnification (Fig. 1D). Of note, the pigment deposition is unequivocally located at villous tips, as is traditionally only appreciated on pathology. Indeed, the pathology report likewise described regular finger-shaped villi with presence of brownish pigmented macrophages within the lamina propria stroma. An ancillary iron stain proved positive, albeit this may provide conflicting results in otherwise characteristic pseudomelanosis ilei.

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