Hose or lead pipe colon: Crohn disease

Case contributed by Dr Chris O'Donnell

Presentation

Past history of Crohn disease. Now abdominal pain and diarrhoea.

Patient Data

Age: 50
Gender: Female
Modality: CT

Caecum is on a mesentery and sits in the right upper quadrant. Ileocaecal junction is normal. Left colon from the hepatic flexure is featureless, shortened and thick-walled - typical features of a so-called "hose or lead pipe".

Case Discussion

The hose pipe pattern is due to gross transmural inflammation of the colonic wall. Note there is also distension of the transverse colon raising the possibility of toxic "megacolon", a potentially life threatening complication of colitis.

The term lead pipe sign is also given to this appearance in ulcerative colitis and Crohns disease.

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Case Information

rID: 27725
Case created: 16th Feb 2014
Last edited: 20th Nov 2015
Inclusion in quiz mode: Included

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