system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 33-year-old man has a history of intermittent bloody diarrhea, tenesmus, fever, fatigue, and lower abdominal cramps for the past 2 weeks. On physical examination, he is lethargic and appears lean and pale. He has aphthous stomatitis, red congested conjunctiva, and tender swollen joints. At the doctor’s office, his pulse is 114/min, blood pressure is 102/76 mm Hg, respirations are 20/min, and his temperature is 39.4°C (102.9°F). There is vague lower abdominal tenderness and frank blood on rectal examination. Laboratory studies show:
Hemoglobin 7.6 g/dL
Hematocrit 33%
Total leucocyte count 22,000/mm3
Stool assay for C.difficile is negative
Abdominal X-ray shows no significant abnormality
He is symptomatically managed and referred to a gastroenterologist, who suggests a colonoscopy and contrast (barium) study for the diagnosis. Which of the following is the most likely combination of findings in his colonoscopy and barium study?
assistant
Colonoscopy: Continuous ulcerated lesions involving the mucosa and submucosa granular mucosa, crypt abscess, and pseudopolyps, Barium study: Lead pipe colon appearance