{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:10:03Z","timestamp":1756307403115,"version":"3.44.0"},"reference-count":15,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,9,30]]},"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:p>A patient was taken to the operating room with a presumptive diagnosis of necrotic small bowel and colon. During the procedure, it was noted that she had black mucosa throughout the colon. Several factors suggested viable colonic tissue, and the decision was made to not resect the colon as originally planned. Final pathology of the specimen would later reveal melanosis coli, an ultimately benign diagnosis. Further questioning of the patient found that she had taken a herbal laxative supplement containing several components which are known to cause melanosis coli. We hope that this case report will serve as a reminder to surgeons and clinicians to remember melanosis coli as a clinical entity when confronted with blackened or darkened colonic mucosa. On review of available literature, we identified other cases in which melanosis coli was discovered intraoperatively, and we propose a number of factors to support intraoperative decision making.<\/jats:p>","DOI":"10.1136\/bcr-2022-250062","type":"journal-article","created":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T08:31:29Z","timestamp":1667205089000},"page":"e250062","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Intraoperative discovery of melanosis coli during emergent bowel resection for perforation"],"prefix":"10.1136","volume":"15","author":[{"given":"Grant","family":"Hubbard","sequence":"first","affiliation":[{"name":"Department of Surgery, Western Reserve Hospital Partners, Cuyahoga Falls, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Prusko","sequence":"additional","affiliation":[{"name":"Department of Surgery, Western Reserve Hospital Partners, Cuyahoga Falls, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan","family":"Christopher","sequence":"additional","affiliation":[{"name":"Lincoln Memorial University Debusk College of Osteopathic Medicine, Harrogate, Tennessee, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald","family":"Russ","sequence":"additional","affiliation":[{"name":"Department of Graduate Medical Education, Western Reserve Hospital Partners, Cuyahoga Falls, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter","family":"Chlysta","sequence":"additional","affiliation":[{"name":"Department of Surgery, Western Reserve Hospital Partners, Cuyahoga Falls, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,10,25]]},"reference":[{"key":"2025082707432962000_15.10.e250062.1","doi-asserted-by":"crossref","first-page":"291","DOI":"10.31662\/jmaj.2021-0031","article-title":"Melanosis coli","volume":"4","author":"Kuriyama","year":"2021","journal-title":"Jma J"},{"key":"2025082707432962000_15.10.e250062.2","doi-asserted-by":"crossref","first-page":"117955221881732","DOI":"10.1177\/1179552218817321","article-title":"Melanosis coli: a helpful contrast effect or a harmful pigmentation?","volume":"11","author":"Abu Baker","year":"2018","journal-title":"Clin Med Insights Gastroenterol"},{"key":"2025082707432962000_15.10.e250062.3","unstructured":"Neshiewat Z , Al Nasser Y . Melanosis coli. STAT pearls Internet. Treasure Island FL: Stat Pearls Publishing, 2021. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK493146\/"},{"key":"2025082707432962000_15.10.e250062.4","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.14.4296"},{"key":"2025082707432962000_15.10.e250062.5","doi-asserted-by":"crossref","DOI":"10.7717\/peerj.4483","article-title":"Gender, age, and concomitant diseases of melanosis coli in China: a multicenter study of 6,090 cases","volume":"6","author":"Wang","year":"2018","journal-title":"PeerJ"},{"key":"2025082707432962000_15.10.e250062.6","doi-asserted-by":"publisher","DOI":"10.1136\/gut.46.5.651"},{"key":"2025082707432962000_15.10.e250062.7","doi-asserted-by":"crossref","DOI":"10.14309\/crj.2016.130","article-title":"Melanosis coli after long-term ingestion of Cape Aloe","volume":"3","author":"Modi","year":"2016","journal-title":"ACG Case Rep J"},{"key":"2025082707432962000_15.10.e250062.8","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2015-212404"},{"key":"2025082707432962000_15.10.e250062.9","first-page":"46","article-title":"Melanosis coli or mucosa ischemia? A case report","volume":"41","author":"Fleischer","year":"1995","journal-title":"Ostomy Wound Manage"},{"key":"2025082707432962000_15.10.e250062.10","doi-asserted-by":"publisher","DOI":"10.1186\/1749-7922-2-25"},{"key":"2025082707432962000_15.10.e250062.11","doi-asserted-by":"crossref","DOI":"10.7812\/TPP\/18-063","article-title":"Melanosis coli: a case of mistaken Identity-A case report","volume":"23","author":"Moeller","year":"2019","journal-title":"Perm J"},{"key":"2025082707432962000_15.10.e250062.12","doi-asserted-by":"crossref","DOI":"10.12659\/AJCR.925753","article-title":"Superior mesenteric artery thrombosis and acute intestinal ischemia as a consequence of COVID-19 infection","volume":"21","author":"Cheung","year":"2020","journal-title":"Am J Case Rep"},{"key":"2025082707432962000_15.10.e250062.13","doi-asserted-by":"crossref","DOI":"10.1111\/ijcp.14930","article-title":"Bowel ischemia in COVID-19: a systematic review","volume":"75","author":"Patel","year":"2021","journal-title":"Int J Clin Pract"},{"key":"2025082707432962000_15.10.e250062.14","doi-asserted-by":"crossref","first-page":"85","DOI":"10.30699\/ijp.2021.525280.2600","article-title":"Intestinal infarction in COVID-19 pandemic: a case series","volume":"17","author":"Sarkardeh","year":"2022","journal-title":"Iran J Pathol"},{"key":"2025082707432962000_15.10.e250062.15","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.14.7302"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-250062","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:43:41Z","timestamp":1756305821000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-250062"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10]]},"references-count":15,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,10,25]]},"published-print":{"date-parts":[[2022,10]]}},"alternative-id":["10.1136\/bcr-2022-250062"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-250062","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2022,10]]}}}