A case report with melanosis coli

Öz

It is widely known that long-term use of anthranoid-containing laxatives can cause melanosis coli. We describe a case of melanosis coli occurring in a 21-year-old woman who took a laxative containing senna. The typical brownish pigmentation of the colonic mucosa developed in a period of two years. Colonoscopy was carried out and the following results were observed: brownish discoloration of mucosa and white pigmented spot areas starting at the 26th cm from anal canal to cecum, edema, polyps and some ulcers in rectum. The medication was stopped. Subsequently, dietary and lifestyle recommendations were explained to the patient. Concern about a possible relationship between melanosis coli and the development of colonic neoplasms was not substantiated in a recent prospective case-control study. Other confounding factors such as chronic constipation or dietary intake may account for an increased risk of colon cancer as suggested by earlier studies. Colonoscopic biopsies should be taken if there is suspicion of colorectal adenoma and cancer.

Anahtar Kelimeler

• Melanosis coli, anthraquinone laxatives, colonic neoplasms

Melanozis kolili bir olgu sunumu

Öz

Uzun dönem antrakuinon içeren laksatif kullanımının melanozis koliye yol açtığı bilinen bir durumdur. Biz burada senna içeren bir laksatif kullanı mına bağlı melanozis koli gelişen 21 yaşındaki bir kadın hastayı sunuyoruz. Hastanın kolon mukozasındaki tipik kahverenkli pigmentasyon 2 yıl içinde gelişmişti. Hastaya yapılan kolonoskopide anal kanaldan sonra yaklaşık 26. cm'den itibaren çekuma kadar olan kolon mukozasında kahverengi renkte, beyaz pigmente spot alanlar görüldü. Rektumda hiperemik ve ödemli, yer yer ülsere, polipoid yapılar izlendi. Bunun üzerine laksatif kullanımı kesildi. Hastaya diyet değişikliği önerildi. Melanozis koli ve kolon kanseri arasındaki ilişkiyi yakın zamanda ispatlamış prospektif vaka kontrol çalışması yoktur. Daha çok çalışmalarda kolon kanseri ile kronik konstipasyon ve diyet arasındaki ilişki üzerinde durulmaktadı r. Kolorektal adenom ve kanser şüphesine karşı kolonoskopik biyopsiler alınabilir.

Anahtar Kelimeler

• Melanozis koli, antrakuinon laksatifler, kolon kanseri

Kaynakça

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