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A case report with melanosis coli

Yıl 2007, Cilt: 6 Sayı: 1, 50 - 52, 01.04.2007

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.

Kaynakça

  • Ghadially FN, Walley VM. Melanosis of the gastrointestinal tract. Histopathology 1994; 25: 197-207.
  • Cruveilhier J. Cancer avec melanose. In: Anatomie pathologique du corps humain. Paris: Baillier; 1829; 6.
  • Benavides SR, Morgante PE, Monserrat AJ, et al. The pigment of melanosis coli: A lectin histochemical study. Gastrointest Endosc 1997; 46: 131.
  • Speare GS. Melanosis coli. Experimental observations on its pro- duction and elimination in twenty-three cases. Am J Surg 1951; 82: 631-6.
  • Mengs U, Rudolph RL. Light and electron-microscopic changes in the colon of the guinea pig after treatment with anthranoid and non- anthranoid laxatives. Pharmacology 1993; 47: 172.
  • Balazs M. Melanosis coli. Ultrastructural study in 45 patients. Dis Colon Rectum 1986; 29: 839.
  • Van Gorkom BAP, DeVries EGE, Karrenbeld A, Kleibeulier JH. Anthranoid laxatives and their potential carcinogenic effects. Aliment Pharmacol Ther 1999; 13: 443-52.
  • Walker NI, Bennett RE, Axelson RA. Melanosis coli: A consequence of anthraquinone-induced apoptosis of colonic epithelial cells. Am J Pathol 1988; 131: 465.
  • Nelemans FA. Clinical and toxicological aspects of anthraquinone laxatives. Pharmacology 1976; 14: 73-7.
  • Koskela E, Kulju T, Collan Y. Melanosis coli: prevalance, distribu- tion, and histologic features in 200 consecutive autopsies at Kuopio University central hospital. Dis Colon Rectum 1989; 32: 235-9.
  • Badiali D, Marcheggiano A, Pallone F, et al. Melanosis of the rec- tum in patients with chronic constipation. Dis Colon Rectum 1985; 28: 241.
  • Lembo A, Camilleri M. Chronic Constipation. NEJM 2003; 349: 1360-8.
  • Talley NJ. Definitions, epidemiology and impact of chronic consti- pation. Rev in Gastroenterol Dis 2004; 4: 3-10.
  • Türkay C, Aydoğan T, Özden A. Konstipasyon tanım ve epidemiye- lojisi. Güncel Gastroenteroloji 2005; 48-52.
  • Siegers CP, Hertzberg-Lottin E von, Otte M, Schneider B. Anthra- noid laxative abuse, a risk for colorectal cancer? Gut 1993; 34: 1099-101.
  • Nusko G, Schneider B, Wittekind C, Hahn EG. Anthranoid laxative use is not a risk factor for colorectal neoplasia: Results of a pros- pective case control study. Gut 2000; 46: 651.
  • Morganstern L, Shemen L, Allen W, et al. Melanosis coli: Changes in appearance when associated with colonic neoplasia. Arch Surg 1983; 62: 118.
  • Hardin RD, Tedesco FJ. Colitis after Hibiclens enema. J Clin Gastroenterol 1986; 8: 572.

Melanozis kolili bir olgu sunumu

Yıl 2007, Cilt: 6 Sayı: 1, 50 - 52, 01.04.2007

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.

Kaynakça

  • Ghadially FN, Walley VM. Melanosis of the gastrointestinal tract. Histopathology 1994; 25: 197-207.
  • Cruveilhier J. Cancer avec melanose. In: Anatomie pathologique du corps humain. Paris: Baillier; 1829; 6.
  • Benavides SR, Morgante PE, Monserrat AJ, et al. The pigment of melanosis coli: A lectin histochemical study. Gastrointest Endosc 1997; 46: 131.
  • Speare GS. Melanosis coli. Experimental observations on its pro- duction and elimination in twenty-three cases. Am J Surg 1951; 82: 631-6.
  • Mengs U, Rudolph RL. Light and electron-microscopic changes in the colon of the guinea pig after treatment with anthranoid and non- anthranoid laxatives. Pharmacology 1993; 47: 172.
  • Balazs M. Melanosis coli. Ultrastructural study in 45 patients. Dis Colon Rectum 1986; 29: 839.
  • Van Gorkom BAP, DeVries EGE, Karrenbeld A, Kleibeulier JH. Anthranoid laxatives and their potential carcinogenic effects. Aliment Pharmacol Ther 1999; 13: 443-52.
  • Walker NI, Bennett RE, Axelson RA. Melanosis coli: A consequence of anthraquinone-induced apoptosis of colonic epithelial cells. Am J Pathol 1988; 131: 465.
  • Nelemans FA. Clinical and toxicological aspects of anthraquinone laxatives. Pharmacology 1976; 14: 73-7.
  • Koskela E, Kulju T, Collan Y. Melanosis coli: prevalance, distribu- tion, and histologic features in 200 consecutive autopsies at Kuopio University central hospital. Dis Colon Rectum 1989; 32: 235-9.
  • Badiali D, Marcheggiano A, Pallone F, et al. Melanosis of the rec- tum in patients with chronic constipation. Dis Colon Rectum 1985; 28: 241.
  • Lembo A, Camilleri M. Chronic Constipation. NEJM 2003; 349: 1360-8.
  • Talley NJ. Definitions, epidemiology and impact of chronic consti- pation. Rev in Gastroenterol Dis 2004; 4: 3-10.
  • Türkay C, Aydoğan T, Özden A. Konstipasyon tanım ve epidemiye- lojisi. Güncel Gastroenteroloji 2005; 48-52.
  • Siegers CP, Hertzberg-Lottin E von, Otte M, Schneider B. Anthra- noid laxative abuse, a risk for colorectal cancer? Gut 1993; 34: 1099-101.
  • Nusko G, Schneider B, Wittekind C, Hahn EG. Anthranoid laxative use is not a risk factor for colorectal neoplasia: Results of a pros- pective case control study. Gut 2000; 46: 651.
  • Morganstern L, Shemen L, Allen W, et al. Melanosis coli: Changes in appearance when associated with colonic neoplasia. Arch Surg 1983; 62: 118.
  • Hardin RD, Tedesco FJ. Colitis after Hibiclens enema. J Clin Gastroenterol 1986; 8: 572.
Toplam 18 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Ayşe Çarlıoğlu Bu kişi benim

Şirin Aytaç Bu kişi benim

Elife Eraslan Bu kişi benim

Cansel Türkay Bu kişi benim

Yayımlanma Tarihi 1 Nisan 2007
Yayımlandığı Sayı Yıl 2007 Cilt: 6 Sayı: 1

Kaynak Göster

APA Çarlıoğlu, A., Aytaç, Ş., Eraslan, E., Türkay, C. (2007). Melanozis kolili bir olgu sunumu. Akademik Gastroenteroloji Dergisi, 6(1), 50-52.

test-5