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Abdominal x-ray demonstrates a featureless descending colon, consistent with a "lead pipe" appearance.
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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.
From the case:
Ulcerative colitis and perianal abscess
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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.