Pseudomelanosis ilei associated with ingestion of charcoal: case report and review of literature.
Melanosis or pseudomelanosis of the gastrointestinal tract refers to an accumulation of pigment deposits in the gastrointestinal mucosa. Pigmentation can affect the entire gastrointestinal tract. Melanosis of the colon is not uncommon, but black pigmentation of the small intestine is extremely rare. We report a case of pseudomelanosis of the terminal ileum in a 52-year-old woman who had ingested a tablespoon of charcoal powder daily for 2 years. Numerous small and medium-sized irregular grayish black pigmentations mostly on the background of geographic light grayish discolored mucosa and some on the normal-looking mucosa were seen on the terminal ileum. The finding was similar to a cut surface of a dragon fruit and we named the lesion 'dragon fruit ileum'. Follow up endoscopy 10 months later revealed no significant change in the pigmentation. We could not search any English literature on this lesion. However, we could find three cases from two papers from Korea describing similar lesions after chronic charcoal ingestion and the papers were reviewed with a report of our case.
Kim
Juhyung
J
Department of Gastroenterology, Korea University Guro Hospital, Seoul, Korea.
Hwang
Jin Ki
JK
Choi
Woo Seok
WS
Lee
Beom Jae
BJ
Park
Jong-Jae
JJ
Kim
Jae Seon
JS
Bak
Young-Tae
YT
Kim
Insun
I
D002606:Charcoal / Q000009:adverse effects* / Q000627:therapeutic use; D003113:Colonoscopy; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D007082:Ileum / Q000473:pathology; D008518:Medicine, East Asian Traditional; D008548:Melanosis / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D008875:Middle Aged; D012651:Self Medication
D002606:Charcoal