Ulcerative colitis and perianal abscess

Case contributed by Natalie Yang
Diagnosis almost certain

Abdomen

x-ray
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Abdominal x-ray demonstrates a featureless descending colon, consistent with a "lead pipe" appearance. 

Abdomen and pelvis

ct
This study is a stack
Axial C+ portal
venous phase
This study is a stack
Coronal C+ portal
venous phase
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Submucosal fat deposition (halo sign) and featureless colon (lead pipe sign) are both in keeping with chronic ulcerative colitis. Additionally a right sided perianal abscess is present. 

This study is a stack
Axial
T2
This study is a stack
Axial T2
fat sat
This study is a stack
Coronal T2
fat sat
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MRI similarly demonstrates submucosal fat deposition, and a right sided perianal abscess. 

Case Discussion

This patient with chronic ulcerative colitis developed a right sided perianal abscess. Perianal complications are much less frequently seen in UC than in Crohn disease... see Crohn's disease vs. ulcerative colitis

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