1. Different Aspects of Colitis
As Shown in
Barium Studies
S. Rad
With Selected Cases From His Own Teaching Files
Tabriz University of Medical Sciences
Tabriz-Iran
S. R.
September 18

2. Remark
Single and double contrast barium studies are efficiently used to delineate luminal or mucosal changes that are essential to diagnose in inflammatory bowel diseases (IBD).
The purpose of showing following examples is to emphasis on the radiological findings for each of the more common insults.
S. R.
September 18

3. Circular collar-button ulcers are usually found in preliminary states.
S. R.
September 18

4. Wide spread tiny ulcerations are sometimes confused with feces inside colon.
S. R.
September 18

5. Lack of colon haustrations favors discrimination of colitis from feces.
S. R.
September 18

6. Proctitis is usually the precursor of IBD
S. R.
September 18

7. Descending colon thanks to its muscular tonus best shows lack of haustrations and swelling of mucosa.
S. R.
September 18

8. Undermining of the ulcers produces some kind of tracking between them.
S. R.
September 18

9. Pseudo-polyp
Pseudo-polyp
Surrounding ulcers around normal parcels of mucosa creates pseudo-polyps.
S. R.
September 18

10. To see the pseudo-polyps air and barium covering is necessary.
S. R.
September 18

11. Double contrast better delineates superficial ulcerations.
S. R.
September 18

12. Different episodes of IBD may be seen in one film.
Toxic mega-colon
Active phase
Fibrotic narrowing in chronic phase
Different episodes of IBD may be seen in one film.
S. R.
September 18

13. Cobble-stone appearance.
Cobble-stoning is the familiar aspect of IBD seen here in descending colon.
S. R.
September 18

14. Negative aspect is much more suitable to show cobble-stoning and undermining
S. R.
September 18

15. Involvement of the left colon is much more common in IBD.
S. R.
September 18

16. Pan-colitis may involve whole length of the colon and is prone to malignant degeneration.
S. R.
September 18

17. Right colon is the last part to be involved in IBD.
S. R.
September 18

18. The same patient to show the incompetency of the ileo-cecal valve for later extension of inflammation.
S. R.
September 18

19. Fairly normal pattern in the right colon.
S. R.
September 18

20. Rigidity of the colon in long segment is named lead-pipe sign.
S. R.
September 18

21. Segmental narrowing creates lead-pipe appearance.
S. R.
September 18

22. Lead-pipe sign in the transverse and descending colon
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23. Lead-pipe sign with fibrotic narrowing
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September 18

24. Extension of the inflammatory process to terminal ileum is called back-wash ileitis.
S. R.
September 18

25. Chronic ulcerative colitis with back-wash ileitis showing dilatation of the terminal ileum.
S. R.
September 18

26. Conclusion
Although inflammatory bowel diseases are easily diagnosed and differentiated from neoplasm but apart from some characteristic signs, recognition of the inflammation types is not so easy because of overlapping of the similar patterns.
S. R.
September 18

27. Thanks for your attention
S. R.
September 18