Ulcerative colitis

Case contributed by A.Prof Frank Gaillard

Presentation

Blood per rectum and abdominal pain.

Patient Data

Age: 35 years
Gender: Male
X-ray

The descending in sigmoid colons show changes consistent with colitis with bowel wall thickening. The appearances of the ascending and proximal transverse colons is unremarkable. There is no small bowel dilatation.

CT

Long segment involvement inflammatory change with extensive bowel wall thickening and narrowing of the lumen involving the descending colon to the level of the distal sigmoid. The rectum is less affected. The transverse colon and ascending colon are relatively spared. The appendix has a normal appearance. Ileo-cecal junction and terminal ileum and have a normal appearance. The small bowel is unremarkable.

Minor mesenteric and pelvic lymphadenopathy. Small amount of free fluid present. No free gas identified. No focal collection identified. The liver, pancreas, kidneys, adrenal glands and

Conclusion:

Findings in keeping with long segment colitis. No evidence of complication such as abscess collection or free gas to suggest perforation.

Differential diagnoses include inflammatory bowel disease (particularly ulcerative colitis) or less likely infective etiologies.

X-ray

5 years later

The descending colon is featureless and thickwalled (lead pipe).

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Case information

rID: 31678
Published: 22nd Jun 2019
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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