Pseudomembranous colitis

Case contributed by Natalie Yang

Presentation

Hospitalized for pneumonia. Now increasing abdominal pain.

Patient Data

Age: 80 years
Gender: Female
ct

The majority of the large bowel, from approximately the hepatic flexure down to the anus, is thick-walled with enhancing mucosa and minor pericolic fat stranding. The lumen is fluid-filled and only mildly distended, particularly distally. There is no free intra-abdominal fluid or gas. No mesenteric gas or portal gas. 

Incidental note is made of a prominent common bile duct and a duodenal diverticulum. 

Annotated image

Annotated images:

  • abnormal colon wall with thickened wall (blue arrow), prominently enhancing mucosa (yellow arrow) and fluid filled lumen (orange arrow). 
  • duodenal diverticulum (red *) is fluid filled, and projects medially. The common bile duct (green *) is enlarged. 

Case Discussion

This case is typical both in terms of presentation and in terms of imaging findings of pseudomembranous colitis. The patient made an uneventful recovery. 

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