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Colonoscopy picture (sigmoid colon) from case No. 1.
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Limited colonoscopy revealed extensive mucosal oedema and erythema with pseudomembranes in the rectum and sigmoid colon suggesting possible Clostridioides difficile-associated pseudomembranous colitis (Figure 1).
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Colonoscopy images from case no. 2.
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An abdominal ultrasound showed left-sided colonic wall thickening and subsequent sigmoidoscopy revealed diffuse mucosal erythema with numerous patchy exudates suggestive of pseudomembranes (Figures 2 and 3).
Additional Colonoscopy images from case no. 2.
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An abdominal ultrasound showed left-sided colonic wall thickening and subsequent sigmoidoscopy revealed diffuse mucosal erythema with numerous patchy exudates suggestive of pseudomembranes (Figures 2 and 3).
Mucosal histopathology pictures from case No. 2.
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Variably dilated crypts partly filled with mucus and neutrophils, with superficial epithelial loss and variably expanded lamina propria were also seen (Figure 4).
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Colonoscopy image of case No. 3.
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So, urgent colonoscopy was performed and it revealed extensive mucosal oedema and erythema with overlying patchy exudates in the rectum and sigmoid, consistent with pseudomembranous colitis (Figure 5).
Mucosal histopathology pictures from case no. 3.
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In addition, surface ulceration with necro-inflammatory pseudomembranous exudate mixed with mucus was seen and these histo-pathological findings were suggestive of pseudomembranous colitis (Figures 6 and 7).
Additional histopathology pictures from case no. 3.
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In addition, surface ulceration with necro-inflammatory pseudomembranous exudate mixed with mucus was seen and these histo-pathological findings were suggestive of pseudomembranous colitis (Figures 6 and 7).
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Abdominal CT of case no. 4.
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Abdominal CT scan showed diffuse large bowel wall thickening suggesting possible infectious pan-colitis (Figure 8).
Colonoscopy pictures from case no. 4.
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Subsequent sigmoidoscopy revealed diffuse mucosal erythema with pseudomembranes (Figure 9).