J Korean Surg Soc.  2011 Jul;81(1):66-69. 10.4174/jkss.2011.81.1.66.

Melanosis ilei induced by prolonged charcoal ingestion

• Kim GM
• Jun EJ
• Kim YC
• Park JM
• Hong SI
• Cheung DY
• Kim JI
• Lee YS

• KMID: 1853534
• DOI: http://doi.org/10.4174/jkss.2011.81.1.66

Abstract

Gastrointestinal melanosis is observed most frequently in the colon it also can develop in the ileum, duodenum and esophagus very rarely. Melanosis ilei was thought that causative materials such as aluminum, magnesium, silicate, titanium and other compounds entered the body through the ingestion of agents. We experienced a case of melanosis in the terminal ileum that a 65-year-old female patient ingested 10 g edible charcoal everyday for 3 years to address symptoms of chronic abdominal pain. In Korea, edible charcoal has been considered to be an effective folk remedy for patients with diarrhea or chronic abdominal pain. In our case, a follow up colonoscopy was performed 3.5 years after the termination of the ingestion of edible charcoal, at which point pigmentation was faded color intensity. In conclusion, it is thought that melanosis ilei is a rare disease by ingestion of causative materials and is discontinuous, local and reversible disease.

Keyword

Melanosis; Ileum; Charcoal; Capsule endoscopy; Electron microscopy

MeSH Terms

Abdominal Pain
Aged
Aluminum
Capsule Endoscopy
Charcoal
Colon
Colonoscopy
Diarrhea
Duodenum
Eating
Esophagus
Female
Follow-Up Studies
Humans
Ileum
Korea
Magnesium
Medicine, Traditional
Melanosis
Microscopy, Electron
Pigmentation
Rare Diseases
Silicates
Titanium
Aluminum
Charcoal
Magnesium
Silicates
Titanium

Figure

• 

  Fig. 1 Colonoscopic features of terminal ileum and capsule endoscopy finding of ileum. (A) The mucosa of the terminal ileum shows punctuate and confluent areas of pigmentation. The lesion is observed as multiple and variable sized geographic black pigmentation spots in the mucosa, and the borders of the lesion are well demarcated. (B) This image shows the well demarcated black pigmented mucosa at terminal ileum.

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  Fig. 2 Histologic features and electron microscopic finding of melanosis ilei. (A) Light microscope shows macrophages containing black coarse pigments (arrow) in the lamina propria and submucosa (H&E, ×200). (B) This image shows pigment granules at the microvilli and cytoplasms of epithelial cells (arrow) (×4,000).

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  Fig. 3 Follow-up colonoscopy 3.5 years later. The pigment deposition was still observable but had diminished in color intensity.

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