What is the main abnormality demonstrated on these plain films?
Prominent mural thickening with thumb-printing - best seen in the descending colon on the supine film.
What is the differential diagnosis?
Features are most likely those of colitis, e.g. infective colitis (including Clostridioides difficile pseudomembranous colitis), ischaemic colitis, inflammatory colitis, radiation colitis, neutropaenic colitis.
Erect and supine abdominal radiographs demonstrate thickening of the descending colon wall, best seen on supine projection. No evidence of a bowel obstruction or free intra-abdominal gas.