Colonic spider naevi in a middle-aged man

Introduction A 59-year-old man was seen in outpatient clinic with a 1-year history of abdominal cramping and non-bloody diarrhoea. His only medical history comprised hypercholesterolaemia and oesophagogastric reflux, for which he took simvastatin and lansoprazole. He did not show cutaneous spider naevi and there was no history of liver disease or use of oestrogen or hormone replacement medications. CT of the abdomen and pelvis showed a long segment of moderate sigmoid colonic wall thickening (figure 1A) with perifocal fat stranding and free fluid in keeping with acute sigmoiditis. Feeding vessels were patent with no evidence of ischaemic colitis. Colonoscopy showed an oedematous and erythematous sigmoid, descending colon and splenic flexure, with multiple telangiectatic lesions or ‘spider naevi’ especially at the splenic flexure (figure 1B). The only histological abnormality of splenic flexure biopsies comprised ‘arteriolised’ capillaries in the lamina propria (figure 1C). There...
Source: Gut - Category: Gastroenterology Authors: Tags: GUT Snapshot, Gut Editor ' s quiz: GI snapshot Source Type: research