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These linear lesions were seen within the left side colon of a lady undergoing colonoscopy because of loose stool. The patient denies taking any medication.
WHAT IS THE LIKELY DIAGNOSIS?
explanation
These linear scars have been described (GIE 2010;71(1):221) in patients with both types of 'microscopic colitis' (collagenous colitis and lymphocytic colitis). Presumably it's because the lamina propria can be fibrotic, which makes the mucosa "brittle" and prone to superficial cracks. When I see these fresh cracks (example below, courtesy of Dr Gareth Davies), in the right hemi-colon of a patient with microscopic colitis, I always thought that I have insufflated too hard. However, they can evidently happen spontaneously and then heal as linear scars. In this case, the subsequent histology confirmed our endoscopic diagnosis of a microscopic colitis.
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