Presentation
Past history of Crohn disease. Now abdominal pain and diarrhea.
Patient Data
Cecum is on a mesentery and sits in the right upper quadrant. Ileocecal 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 (lead 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.