pseudomembranous colitis

Male, abdominal pain

CT findings: the ascending, transverse and descending colon walls were significantly thickened, the inner wall was irregular, and the serosa was smooth; the colonic lumen was narrowed but not obstructed

Results: pseudomembranous colitis

Pseudomembranous Colitis (PMC) is an acute fibrinous exudative inflammation that mainly occurs in the colon and small intestine.

Scope of lesions: the whole colon or segmental colon can be involved, and the lesion rate of rectum and sigmoid colon is 80%-100%

(1) Thickening of the colon wall in patients with pseudomembranous colitis can be found by conventional CT scans.

②Target sign Due to mucosal congestion and submucosal edema, two or three concentric circle signs with different densities can be seen on CT images, which are called "target sign"

③Accordion sign Oral positive contrast agent accumulates in the wide and thickened transverse folds of the colon to form "accordion sign"

④ The incidence of periintestinal exudation is high, but it is not a characteristic manifestation of PMC, and other enteritis can also occur

⑤ Ascites Ascites as a complication of PMC often occurs in more severe cases

⑥ Other findings showed that the mesangial lymph nodes increased and enlarged, which reflected the severity and duration of intestinal inflammation

It is worth noting that in some cases, multiple line-like calcifications of colonic vessels were found, showing a centipede-like change, and some of them passed vertically through the muscular layer of the intestinal wall

CT enhancement can provide more valuable information, such as discontinuous enhancement of the colonic mucosa, thickening of periintestinal vascular congestion, etc.

Colonic thickening, dilation and ascites reflected by CT images are one of the diagnostic criteria for severe PMC