Cytomegalovirus infection is usually reported in immunocompromised patients. In this study, apparently immunocompetent patients with cytomegaloviral colitis were reviewed. Records with a diagnosis of cytomegaloviral colitis from January 1989 to June 1996 were retrieved for analysis. Ten patients were included (median age 70 yr). The major presenting symptoms were diarrhea and hematochezia. Ulceration was the main macroscopic finding. Rectal bleeding was mostly self-limiting. Three patients developed local complications (rectovaginal fistula in two; rectal stricture in one). In the two patients with rectovaginal fistula, lymphocytes subsets and proliferative response were entirely normal. In the other patient, low B lymphocyte count and low response to mitogen were demonstrated. However, the immunoglobulins were not suppressed and rectal biopsies revealed noncaseating granulomas, suggesting activated cell-mediated immunity. In conclusion, a high index of suspicion is crucial for early diagnosis of cytomegaloviral colitis in patients with bloody diarrhea, even though obvious evidence of immunodeficiency is lacking.

The estimated prevalence of chronic idiopathic constipation in Hong Kong is 14%. An expert panel of local gastroenterologists has created a set of consensus statements with the aim of providing localised guidance on the diagnosis and management of this common condition by primary care physicians. Participants: An expert panel consisting of seven local gastroenterologists convened in August 2018 in Hong Kong. Evidence: Published primary research articles, metaanalyses, and guidelines and consensus statements issued by different regional and international societies on the diagnosis and management of chronic idiopathic constipation were reviewed. Consensus process: Draft consensus statements were prepared prior to the meeting. The consensus statements were finalised during the meeting with contributions from the panel members based on their collective knowledge and clinical experience. Conclusions: A total of 11 consensus statements were created, including five concerning patient assessment and diagnosis, two relating to nonpharmacological management, and four on Consensus statements on diagnosis and management of chronic idiopathic constipation in adults in Hong Kong

Behçet's disease, as initially described, is a triad of recurrent oral and genital ulcers and relapsing uveitis. The incomplete form, in which there is no ocular involvement, has been described in Japan and Korea, but this is not commonly recognized in the southern Chinese. We reported herein a rare case of repeated intestinal perforations caused by an incomplete form of Behçet's syndrome in a southern Chinese man.