Collagenous colitis with mucosal tears on endoscopic insufflation: a unique presentation

Collagenous colitis (CC) is a clinicopathological syndrome of indeterminate aetiology, characterised by: (1) chronic watery diarrhoea and crampy abdominal pain and (2) thickened subepithelial collagen table and increased intraepithelial lymphocytes on histology.1,2 Gastrointestinal, radiographic, and endoscopic examinations are not diagnostic of CC. Endoscopically, the colorectal mucosa is usually normal, although some non-specific findings such as erythema or oedema have been reported in up to one third of cases. The endoscopic reports and medical records of each patient were reviewed, including prior colonoscopic examination reports. Two pathologists (MT, JHY) reviewed the patients' colorectal mucosal biopsies. Three patients (two females aged 73 and 61 years; one male aged 62 years) were referred for …