Apple-bite colon in a child

A 10 year old girl presented with frequent painless bleeding per rectum and moderate splenomegaly for 18 months. There was no history of variceal bleeding. Systemic examination was normal. Hemogram was suggestive of hypersplenism (hemoglobin: 9.7 g%, total leucocyte count 4000/mm3, platelet count 85,000/mm3) with normal liver function tests. Colonoscopy showed large deep punched out discrete ulcers with everted edges and white exudates (Fig 1A, B) in rectosigmoid and normal areas in the rest of the colon.
Source: Digestive and Liver Disease - Category: Gastroenterology Authors: Tags: Image of the Month Source Type: research