![]() ![]() The patient was started on steroid and mesalamine therapy. Colonoscopy the following day reported inflammation characterized by congestion (edema), erosions, erythema, friability, granularity, confluent ulcerations, deep ulcerations, and serpentine ulcerations in a continuous and circumferential pattern from the sigmoid colon to the terminal ileum, sparing the mid-sigmoid colon, distal sigmoid colon, and the rectum (Figure 1). CT scan of the abdomen noted findings suggestive of inflammatory bowel disease (IBD) with diffuse areas of active inflammation in the colon. ![]() Stool studies were negative for Cryptosporidium, Giardia, Campylobacter, Shigella, Clostridioides difficile, ova, and parasites. Laboratory data were significant for elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). His physical examination was unremarkable. His symptoms were associated with chills, lower abdominal discomfort, poor appetite, and weight loss of approximately 10-15 pounds. A 68-year-old man with a medical history of pulmonary embolism and chronic obstructive pulmonary disease presented with chronic diarrhea of 8-10 weeks. ![]()
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