Colonic Pseudolipomatosis: A Spectrum of Two Illustrated Cases of an Uncommon Condition

Colonic pseudolipomatosis (CP) is a rare, benign condition typically identified incidentally during routine colonoscopies. Characterized by gas-filled vacuoles within the colonic mucosa, CP is often asymptomatic and self-limiting but can be misinterpreted as more serious conditions, such as ischemic colitis or pseudomembranous colitis. We report two cases of CP with distinct clinical presentations: a 55-year-old asymptomatic male patient with an incidental lesion found during routine screening and a 73-year-old male who developed lower gastrointestinal bleeding 10 days after an extended colonoscopy with multiple polypectomies. Histopathological analysis confirmed CP in both cases. The first patient required no further intervention, while the second underwent supportive care and a follow-up colonoscopy, which showed resolution of the lesions. These cases highlight the spectrum of CP, emphasizing the importance of recognizing this entity to avoid misdiagnosis and unnecessary interventions. Furthermore, they underscore the role of careful endoscopic techniques and disinfection protocols in minimizing the occurrence of iatrogenic CP.