QuestionSBA
QuestionChoice
This is the most important differential diagnosis to rule out. However, these endoscopy findings make colorectal carcinoma unlikely; no tumours are seen. The endoscopy image shows multiple outpouchings of the intestinal wall, consistent with diverticular disease. Constipation is a risk factor for this.
10035418
b
Colorectal carcinoma
QuestionChoice
Angioectasias are common vascular lesions of the digestive tract and may cause chronic, recurrent lower GI bleeding. These appear as red 'coral reef' structures on endoscopy, and may be associated with aortic stenosis (this is called Heyde's syndrome). In this case, the endoscopy shows outpouchings of the intestinal wall, consistent with diverticular disease.
10035419
c
Angioectasia (angiodysplasia)
QuestionChoice
There are no polyps demonstrated in this image. The endoscopy image shows multiple outpouchings of the intestinal wall, consistent with diverticular disease.
10035421
e
Bleeding polyp
QuestionChoice
The endoscopy image shows multiple outpouchings of the intestinal wall, consistent with diverticular disease. Constipation is a risk factor for this. #
10035417
a
Diverticular disease
QuestionChoice
Inflammatory bowel disease would be a good differential in this case, however, the absence of systemic features makes this less likely. Endoscopy would show mucosal inflammation. In this case, the endoscopy image shows multiple outpouchings of the intestinal wall, consistent with diverticular disease.
10035420
d
Inflammatory bowel disease
Concept
Chapter
2693
6129
Diverticular disease
Topic
135
General surgery
19487
Diverticular disease is characterised by the formation of outpouchings in the colon, often associated with constipation and rectal bleeding.
Picture
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A 56-year-old man with multiple episodes of rectal bleeding undergoes a colonoscopy under the 2-week wait pathway. He reports a history of long-standing irritable bowel syndrome with constipation.

The following appearance is seen in the sigmoid colon:

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What is the most likely cause of his symptoms?
a