2017-05-16 13:30:28 UTC

A Unique Cause of Persistent Diarrhea

May 16, 2017

This Gastroenterology image challenge highlights the case of a 60-year-old man with a history of intermittent diarrhea now experiencing approximately five episodes a day.

Gastroenterology Clinical Image Challenge: A 60-year-old man with a five-year history of intermittent diarrhea had been experiencing approximately five episodes a day when he visited the hospital. The diarrhea was watery, and he had no abdominal pain, but slight edema was noted in his lower legs. Blood test results revealed decreased albumin level of 1.5 g/dL, normal C-reactive protein level, and increased serum-soluble interleukin-2 receptor (sIL-2R) level of 1443 U/mL. Upper GI endoscopy revealed many small white nodules throughout the esophagus (Figure A), and the duodenal mucous membrane was edematous and rough (Figure B). On lower GI endoscopy, small white erosions were found throughout the colon (Figure C, narrow-band imaging), and the rectal mucous membrane was edematous (Figure D), although no abnormality was found in the terminal ileum.

What is the diagnosis?

To find out, read the full case in Gastroenterology or download our Clinical Image Challenge app through AGA App Central, which features new cases each week. Sort and filter by organ, most popular or favorites. AGA App Central is available in both the Apple App Store and Google Play

More on Diarrhea

Principles of Gastroenterology for the NP and PA

Aug. 11, 2017

Hear from the experts as they provide you with critical updates on treating and managing patients with a variety of GI disorders.

Pseudomembranes Carpet the Right Colon as a Result of Collagenous Colitis

April 29, 2017

A 48-year-old woman was referred because of watery non-bloody diarrhea, abdominal pain, and weight loss.

Colonic Transit and Bile Acid Synthesis or Excretion in Patients With Irritable Bowel Syndrome–Diarrhea Without Bile Acid Malabsorption

April 29, 2017

In the absence of overt BAM, the total, primary, and secretory BAs in stool contribute to the acceleration of colonic transit and fecal weight in the diarrhea of patients with IBS-D.