RadiologySpirit: colon

Saturday, June 12, 2010

ESSENTIALS
-Many patients with inflammatory or infectious types of colitis present with abdominal pain, and multidetector CT is often used as the initial diagnostic test.
-CT can accurately depict the bowel wall and help determine the presence and extent of intramural disease, its possible extraluminal extension, and involvement of distant sites.
-Many imaging features or patterns are helpful in distinguishing the various types of colitis, including degree of wall thickening, extent and location of disease, extraluminal manifestations, and types of complication.
-While imaging features can help narrow the differential diagnosis or suggest a specific diagnosis, the final diagnosis is often based on clinical and laboratory data and colonoscopic and biopsy findings.

radiology.rsna.org/content/240/3/623.full

Ischemic colitis in an 81-year-old woman with myocardial infarction. (a) Anteroposterior CT scout view shows air (arrows) in wall of right colon and small- and large-bowel dilatation. (b) Transverse CT image demonstrates air (arrowheads) in wall of right colon, with lack of wall enhancement and pericolonic stranding indicative of infarction.

radiology.rsna.org/content/240/3/623.full

Transverse CT image in a 22-year-old woman with ischemic colitis after blunt abdominal trauma to right flank demonstrates marked thickening of hepatic flexure and right colon, with abrupt transition (arrows) between abnormal and normal wall in the transverse colon.

radiology.rsna.org/content/240/3/623.full

Transverse CT image in a 71-year-old man with ischemic colitis due to arrhythmia shows ascites and marked thickening of sigmoid colon associated with multiple large nodular defects, which are the CT analog of thumbprinting (arrows) on radiographs. Note that rectal wall (arrowheads) is normal.

radiology.rsna.org/content/240/3/623.full

Transverse CT image in a 45-year-old male transplantation patient with neutropenic colitis shows marked wall thickening in ascending colon (arrow) associated with pericolonic stranding and ascites (arrowheads).

radiology.rsna.org/content/240/3/623.full