Pseudo–obstruction with pitch black colon - A very rare Presentation of Melanosis Coli

Melanosis coli is associated with an increased risk of colorectal tumors but is not agreed to be a precancerous lesion. The condition has been associated with the ingestion of anthracene laxatives and is believed to be caused by increased epithelial apoptosis. Although melanosis coli is a frequent finding in colonic biopsies and resection specimens, to our knowledge severe jet black melanosis coli with pseudo-obstruction has not been reported in literature. Such gross Melanosis is exceptional and particularly striking.