Colitis

Case contributed by Dr Paul Simkin

Presentation

Lower abdominal pain and diarrhoea.

Patient Data

Age: 90
Gender: Female
Modality: X-ray

Abdomen x-ray

The descending and sigmoid colon shows a featureless mural pattern with loss of normal haustral pattern, suggesting mucosal thickening. No features of obstruction. No pneumoperitoneum.

Conclusion:

Distal colitis.

Modality: CT

From the mid transverse colon distally there is diffuse colonic bowel wall thickening consistent with mucosal oedema. Associated pericolic stranding is shown. There is no pericolic abscess or perforation. The left lateroconal fascia is thickened. This abnormality extends through the sigmoid colon to the rectosigmoid junction. There is no free air in the abdomen or pelvis.

There are some sparse contrast filled sigmoid diverticulae. The ascending colon and hepatic flexure are normal. 

Moderate sized sliding hiatus hernia.

There is some expansion of the body of the left adrenal gland suggesting a mass measuring 22 x 13 mm on axial scanning. 

Free fluid is shown in the pelvic recesses.

CONCLUSION:

There is a long segment colitis extending from transverse colon to the rectosigmoid junction.

The differential diagnosis for this would include ischaemic colitis, inflammatory bowel disease and pseudomembranous colitis.

Case Discussion

The differential diagnosis for this would include ischaemic colitis, inflammatory bowel disease and pseudomembranous colitis.

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Case Information

rID: 33494
Case created: 14th Jan 2015
Last edited: 29th Mar 2017
Tag: colitis
Inclusion in quiz mode: Included

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