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Case prepared by: Jason Daniels
GI Pathology Fellow
Attending: Elizabeth Montgomery, M.D.
  Case 29
Clinical History: 93 year old male with symptoms of diarrhea undergoes flexible sigmoidoscopy with biopsy of a grossly unremarkable segment of sigmoid colon. The next day, the patient perforated in the ascending colon which necessitated surgical intervention. What is the mechanism of injury that required the subsequent resection?
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Choose the correct diagnosis:
  a. Systemic vasculitis caused ischemic injury
  b. Osmotic diuresis from bowel preparation caused ischemic injury
  c. Insufflation from endoscopy physically tore the bowel wall
  d. Activation of the coagulation cascade caused thrombotic ischemic injury
 



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