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Accordion sign

The accordion sign is seen on CT examinations of the abdomen and refers to the similarity between the thickened oedematous wall of pseudomembranous colitis to that of an accordion. The appearance arises as a result of oral contrast being trapped between oedematous haustral folds and pseudomembranes formed on the surface of the colon 2.

Although it has been reported to be a specific sign of severe Clostridium difficile related colitis, it has also been described in other forms of non specific or ischaemic colitis or non-clostridial infective colitis 1.

Occasionally the hyperaemic enhancing mucosa is stretched over markedly thickened submucosal folds, simulating the accordion sign even in the absence of oral contrast material.

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