34 Ulcerative Lesions of the Colon

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

Fig GI 34-1 Early ulcerative colitis. Fine granularity of the mucosa reflects the hyperemia and edema that are seen endoscopically.

• Fig GI 34-2 Aphthoid ulcers of early Crohn's colitis. Punctate collections of barium are surrounded by lucent halos of edema (arrows).

• Fig GI 34-3 Ischemic colitis. Superficial ulcers and inflammatory edema produce a serrated outer margin of the barium-filled colon simulating ulcerative colitis.

• Fig GI 34-4 Amebic colitis. Deep, penetrating ulcers produce a bizarre appearance.

• Fig GI 34-5 Salmonella colitis. Multiple small ulcers and a stippled appearance representing fine ulcerations or erosions are diffusely visible in the ascending and transverse colon.43

Fig GI 34-6 Pseudomembranous colitis. The shaggy and irregular margins reflect the pseudomembrane and superficial necrosis with mucosal ulceration.

• Fig GI 34-7 Pancreatitis. Spiculation of the proximal transverse colon and splenic flexure (arrows) simulates an ulcerating colitis.

• Fig GI 34-8 Ulcerated primary carcinoma of the sigmoid colon (arrow).

Fig GI 34-9 Carcinoma of the prostate metastatic to the rectum and rectosigmoid. The diffuse circumferential ulceration mimics ulcerative colitis.

• Fig GI 34-10 Carcinoma of the stomach metastatic to the transverse colon. Localized right-sided ulceration and narrowing (arrow) simulate Crohn's colitis.

• Fig GI 34-11 Nonspecific benign ulcer of the colon. Area of narrowing in the proximal transverse colon with ulceration along its inferior aspect and marginal spiculation (arrow).44