Peculiar acute toxic colitis after ingestion of colocynth: a clinicopathological study of three cases. Issue 10 (October 1989)

• Record Type: Journal Article
• Authors: Goldfain, D; Lavergne, A; Galian, A; Chauveinc, L; Prudhomme, F
• Is Part Of: Gut. Volume 30:Issue 10(1989)
• Page Start: 1412
• Page End: 1418
• Publication Date: 1989-10
• Subjects: Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gut.30.10.1412
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : We report three examples of toxic acute colitis which occurred after ingestion of colocynth (Citrullus colocynthis) for ritual purposes. The prominent clinical feature was dysenteric diarrhoea; colonoscopic changes included congestion and hyperaemia of the mucosa with abundant exudates but no ulceration or pseudopolyp formation. A causal relationship between colonic injury and the intake of colocynth was supported by the following features: (1) the pharmacology of the colocynth extract ingested; (2) the temporal relationship between colocynth intake and clinical onset (eight to 12 h); (3) the rapid recovery within three to six days, with normal endoscopy at day 14; (4) the absence of other possible causes for the observed patterns, except in one case, in which a concomitant intestinal infection with Clostridium perfringens Type A was discovered; (5) the specific pathological features. Colonic biopsies taken 27, 44, and 72 h after colocynth intake showed: erosions with fibrino-purulent exudate, early fibrosis of the lamina propria, hyaline thickening of the superficial epithelial basal membrane. These pathological features completely disappeared within 14 days in all three cases.