Ulcerative colitis - thumbprinting and lead pipe signs

Case contributed by Dr Henry Knipe

Presentation

Abdominal pain.

Patient Data

Age: 20 years
Gender: Female
X-ray

Abdominal radiograph

Thumbprinting of ascending and transverse colon and featureless bowel wall at the left transverse colon extending into splenic flexure, consistent with wall thickening.

  • yellow arrow = lead pipe sign of the distal transverse colon
  • red arrow = thumbprinting of the proximal transverse colon

Case Discussion

This patient had a known history of ulcerative colitis. The thumbprinting represents wall edema and likely represents more acute (active) disease, with lead pipe appearance more distally representing chronic disease. 

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Case information

rID: 52428
Published: 8th Apr 2017
Last edited: 31st May 2018
Inclusion in quiz mode: Included

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