An Unusual Appearance of the Colon Wall

Question: A 64-year-old man presented for his first average-risk screening colonoscopy. The patient reported occasional abdominal cramps, but was otherwise without any symptoms or medical problems. Physical examination was unremarkable, and review of medical records revealed normal blood counts and serum electrolytes. Colonoscopy with white light and narrow band imaging revealed discrete areas of whitish adherent plaques surrounded by erythematous mucosa in the ascending colon (Figure A). The intervening colonic mucosa seemed to be normal, as did the terminal ileum.

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