Ulcerative colitis

Case contributed by Mahmoud Nady Hassan Mostafa
Diagnosis almost certain

Presentation

Bloody stool and chronic abdominal pain.

Patient Data

Age: 25 years
Gender: Male
ultrasound
Longitudinal
Transverse
Transverse
Oblique
Oblique
Transverse
Transverse
Oblique
Longitudinal
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Info
  • Diffuse colonic mural thickening involving the different parts of the colon (caecum, ascending, transverse and descending colon) with maximum thickness 8 mm, smooth serosal surface and loss of normal haustral markings (featureless colon).
  • Minimal free fluid collection is seen at the right para colic gutter. No mesenteric fat stranding.
  • The small bowel is likely spared
ct
This study is a stack
Axial C+
arterial phase
This study is a stack
Axial C+ portal
venous phase
This study is a stack
Axial C+
delayed
This study is a stack
Coronal C+ portal
venous phase
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Info
  • Diffuse circumferential mural thickening involving all different parts of the colon (from anus to the caecum) with featureless colon (lead pipe appearance of colon).
  • No free fluid or free gas.
  • Congested mesentery.
  • Subcentimetre mesenteric lymph nodes.
  • The terminal ileum and the remainder of the small bowel is spared.
  • Abdominal and pelvic organs appear normal.
  • No suspicious bone lesion.
  • Clear lung bases.

Case Discussion

Findings of diffuse colonic thickening with sparing of small bowel in a young adult most likely due to ulcerative colitis.

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