Danger of linear mucosal tears in collagenous colitis

Published: 04/03/2012

Authors: Hussain Z, Kelly S, Clarke A and Miller G

A 71-year-old lady underwent a colonoscopy for watery non-bloody diarrhoea. Superficial linear mucosal tears of the transverse colon were seen (Fig. 1). She subsequently developed an acute abdomen and underwent laparotomy and subtotal colectomy. Histological examination revealed marked thickening of the subepithelial collagen plate consistent with collagenous colitis. Collagenous colitis affects middle-aged and elderly women. The deposition of subepithelial collagen in the colonic mucosa makes this layer stiff and susceptible to tearing under pressure during air insufflation.