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The Old Endoscopy Quiz (and Answer) of the Month
July 1999

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Question:

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This quite old lady was examined because of an leftsided ulcerative colitis, which she had suffered from for over 20 years. She had no symtoms. This is the finding at the rectosigmoid flexure. It is not a usual adenoma. What is it? And what are the consequences of this finding?

Answer:

This finding is a dysplasia associated lesion or mass (DALM), and is a clear indication for colectomy. The risk of a coinsident carcinoma in other parts of the colon is high.

Correct answers were emailed by:

Burger Alexander, Vienna, Austria
Antonio Sia Neto, Patrocinio, Brazil
Rogério Godinho, Barreiro, Portugal
Curt Tysk, Orebro, Sweden
Leslie Schomer, Connellsville, PA
Ervin Tóth, Malmö, Sweden
German Lloret Salom, Alzira, Spain
Pierre Gholam, New York, USA

Comments:

DALM (if not a alredy advanced carcinoma because the central depression!. Total colectomy should be performed.)

This an villous adenoma.The treatment is proctocolectomy with pouch formation ( with ileostomy or pouch formationand anal sphncter preservation.

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