Endoscopic Features and Mucosal Patterns Associated With Collagenous Colitis

Aims Collagenous colitis (CC) is a morphological and clinical-pathological entity of microscopic colitis, characterized by secretory-like aqueous chronic diarrhea, mostly without hematochezia. Although there are no mucosal abnormalities, in some cases particular endoscopic features and mucosal patterns may be described. We have evaluated the endoscopic findings in patients diagnosed with CC in our Digestive Endoscopy Unit.

Methods We conducted a descriptive and retrospective study that included 228 colonoscopies performed from january 2004 to october 2020 in 213 inpatient and outpatient (78 males and 135 females, mean age 62.7 years) suffering from CC. Colonoscopies report were retrieved, and among the recorded data, we detected alteration of mucosal patterns and endoscopic manifestations which have been associated with CC. According in our experience, we report multiple “mucosal tears” and “scars” following mucosal lacerations as the most frequent finding of textural alteration and mucosal abnormality.

Results In the study period, 213 patients were diagnosed with CC. The main indication for colonoscopy was acute or chronic diarrhoea, sometimes associated with weight loss. In our experience, CC is associated with normal colonoscopy (172/228). Endoscopic findings revealed a mild erythema and edema, red spots with increased mucosal nodularity and mucosal tears in the sigmoid and descending colon, and evidence of erythema, congestion, multiple longitudinal mucosal tears and few scars in right colonic segment explored (56/228). Mucosal tears are linear mucosal defects, and together with other types of mucosal breaks (cat-scratch) as a typical characteristic colonoscopic findings in patients with CC, and may have an increased risk of colonic perforation during the colonoscopy procedure.

Conclusions A minority of patients with CC, almost 25 %, presented endoscopic findings indicative of CC. Knowledge of typical abnormalities and mucosal patterns could help to identify endoscopic features and to target the colonic biopsies to reach the diagnosis.

Citation: Labianca O, Sica M, Zulli C etal. eP271 ENDOSCOPIC FEATURES AND MUCOSAL PATTERNS ASSOCIATED WITH COLLAGENOUS COLITIS. Endoscopy 2021; 53: S187.

Publication History

Article published online:
19 March 2021