Three Cases of Colonic Pseudolipomatosis Induced by Endoscope Disinfectant / 대한소화기내시경학회지

Colonic pseudolipomatosis is a benign condition that is caused by mechanical trauma during an endoscopic procedure or by disinfectant colitis. It is characterized by empty vacuoles that are similar to the adipocyte in the lamina propria on histology and whitish plaques that are seen endoscopy. The prevalence of pseudolipomatosis is relatively low due to the lack of clinical experience and there have been no Korean reports about colonic pseudolipomatosis with the typical endoscopic findings. We report here on three cases of colonic pseudolipomatosis that was caused by endoscope disinfectant (paracetic acid). Typical whitish plaques were observed during the colonoscopic procedures in all 3 cases. In one case, whitish plaques appeared before our eyes immediately after the sudden appearance of whitish foamy fluid when the water button was depressed. H&E stain revealed empty vacuoles in the lamina propria and immunohistochemical staining showed no expression of CD31, CD34 and s-100. There were no symptoms related to these lesions in our cases.

A Case of Pseudolipomatosis in the Gastric Mucosa / 대한소화기내시경학회지

Mucosal pseudolipomatosis is a recently described endoscopic finding consisting of benign transient lesions. This condition, resembling fatty infiltration, is characterized by the presence of small gas voids in the gastrointestinal wall, particularly in the mucosa. The frequency of colonic pseudolipomatosis is higher than the frequency of pseudolipomatosis of the stomach. Both mechanical and chemical theories have been offered to explain the pathogenesis of colonic pseudolipomatosis. The mechanical theory pertains to an air pressure-related complication of the colonoscopy procedure. The chemical theory concerns a drug-related complication of the detergent used during colonoscopies. However, the pathogenesis of gastric pseudolipomatosis is still unclear. Recently, we had a patient who experienced gastric pseudolipomatosis after endoscopoy and biopsy procedures. In the following report we discuss this interesting case of gastric pseudolipomatosis.

Pseudolipomatosis of the Gastrointestinal Mucosa: Report of 6 cases with analysis of possible factors involved during endoscopic procedure

Pseudolipomatosis of the colonic mucosa has been recognized as a lesion featured with aggregations of gaseous spaces in the lamina propria, but its pathogenesis remains still unclear. This paper describes 6 cases of pseudolipomatosis occurring in the mucosa of stomach and large intestine, and the possible factors involved in gastrointestinal endoscopic procedure to produce gaseous entrapment in the lamina propria were analysed. All cases received either gastroscopy or colonoscpy before endoscopic biopsy. Mucosal tissues from both stomach and recto-sigmoid colon revealed multiple aggregations of small air-spaces resembling fatty infiltration in the lamina propria. Rarely were similar infiltrations within the muscularis mucosae and adjacent lymphoid follicles. Evidence for pneumatosis cystoides intestinalis or ulcerative colonic lesion was not associated, although one showed a small gastric ulcer nearby. Repeated inflations and deflations of the stomach or colon during the endoscopic procedure with miner mechanical trauma by instrument to the mucosa seem to contribute to its pathogenesis.