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An unusual colitis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "714" "paginaFinal" => "715" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Javier Jiménez Sánchez" "autores" => array:1 [ 0 => array:3 [ "nombre" => "Javier" "apellidos" => "Jiménez Sánchez" "email" => array:1 [ 0 => "javi.jimenez.san28@gmail.com" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Sección de Aparato Digestivo, Hospital Vega Baja, Orihuela, Spain" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "<span class="elsevierStyleItalic">Snow white sing</span>. Una colitis inusual" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 526 "Ancho" => 1340 "Tamanyo" => 136986 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Snow white sign. Multiple whitish foamy plaques, some converging, confined to the ascending (A) and transverse colon (B), after instillation of water, with traces of peracetic acid in the endoscope channels.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 72-year-old male undergoing a colonoscopy (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) as a result of constipation was found to have a 5-mm flat polyp, which was removed. When water was instilled to aid recovery, we became aware of the sudden appearance of whitish lesions (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">The “snow white sign” corresponds to colonic pseudolipomatosis, a rare iatrogenic colitis with an aetiology related to residues of disinfectant solutions, in our case peracetic acid, in the channels of the endoscope. Histologically, small gas cysts in the lamina propria, similar to fat, are striking, differing from lipomatosis by the absence of lipids; hence the name. Patients are asymptomatic and lesions disappear spontaneously within 3–20 months.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The variety of lesions of diverse aetiology we come across means it is essential to have a large atlas to help us correctly characterise the endoscopic patterns and adopt the most appropriate action. The importance of this case therefore lies, on the one hand, in the need to be aware of this unusual and striking benign lesion and not to confuse it with other similar lesions, such as pseudomembranous colitis, colonic lipomatosis or malakoplakia, and, on the other, in our obligation to have an adequate protocol for cleaning, disinfection and rinsing of equipment, in order to avoid such occurrences.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical considerations</span><p id="par0020" class="elsevierStylePara elsevierViewall">The work was conducted in accordance with the Code of Ethics of the World Medical Association.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Funding</span><p id="par0025" class="elsevierStylePara elsevierViewall">None.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">None.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Ethical considerations" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Funding" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflicts of interest" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 786 "Ancho" => 1005 "Tamanyo" => 130621 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Ascending colon segment with excellent preparation, Boston 3/3/3, after instillation of water.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 526 "Ancho" => 1340 "Tamanyo" => 136986 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Snow white sign. Multiple whitish foamy plaques, some converging, confined to the ascending (A) and transverse colon (B), after instillation of water, with traces of peracetic acid in the endoscope channels.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Colonic mucosal pseudolipomatosis: are we aware of it?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Ersöz" 1 => "A.B. Toros" 2 => "E. Çakar" 3 => "M.E. Güneş" 4 => "S. Çulcu" 5 => "S. Sari" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5152/UCD.2015.2886" "Revista" => array:5 [ "tituloSerie" => "Turkish J Surg" "fecha" => "2016" "volumen" => "32" "paginaInicial" => "90" "paginaFinal" => "92" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Colonic mucosal pseudolipomatosis: disinfectant colitis?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.J. Kim" 1 => "I.H. Baek" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/SGA.0b013e3182562bde" "Revista" => array:6 [ "tituloSerie" => "Gastroenterol Nurs" "fecha" => "2012" "volumen" => "35" "paginaInicial" => "208" "paginaFinal" => "213" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22647801" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/24443824/0000004600000009/v2_202401260608/S2444382423001670/v2_202401260608/en/main.assets" "Apartado" => array:4 [ "identificador" => "75461" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images of the month" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/24443824/0000004600000009/v2_202401260608/S2444382423001670/v2_202401260608/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444382423001670?idApp=UINPBA00004N" ]
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Vol. 46. Issue 9.
Pages 714-715 (November 2023)
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Vol. 46. Issue 9.
Pages 714-715 (November 2023)
Image of the month
Snow white sign. An unusual colitis
Snow white sing. Una colitis inusual
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147
Javier Jiménez Sánchez
Sección de Aparato Digestivo, Hospital Vega Baja, Orihuela, Spain
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