Presentation
New diagnosis of ulcerative colitis. Worsening abdominal pain.
Patient Data
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Nodular indentations of an otherwise relatively featureless ascending and transverse colon. The appearance is consistent with 'thumbprinting'.
The distal colon is not illustrated.
Normal small bowel. No pneumoperitoneum.
Case Discussion
Thumbprinting is the term used for the plain radiograph appearance of colitis. It is most commonly observed in ulcerative colitis as was the diagnosis in this young patient.
It is a thumb (or nodular) shaped indentation of the colon which is thickened with mucosal edema. The bowel is often also featureless.