Spider-Man Was Here and NSAIDs Were Not: Report of a Nonobstructing Fenestrated Colonic Mucosal Web Complex Seen on Colonoscopy

A cholecystokinin (CCK) scintigraphy hepatobiliary iminodiacetic acids showed a patent cystic duct, an ejection fraction of 97%, and no reproduction of symptoms with CCK infusion. Since endoscopy, she had some changes in her diabetic medications. Colonic web/diaphragm disease is a very rare entity; its incidence is unknown and is a very rare cause of obstructive symptoms in pediatric patients and adults.1,2 While diaphragm disease is more common in the pediatric population, it remains a very rare occurrence. 1 In pediatric patients, webs are commonly congenital and most likely localized in the small bowel. Given that the patient had some pseudopolyp disease and a hepatic flexure ulcer in the past, the suspicion is that it is potentially idiopathic, or perhaps secondary to some mild focal ischemic colitis of a watershed area of the colon.