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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
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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
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Circular collar-button ulcers are usually found in preliminary states.
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Wide spread tiny ulcerations are sometimes confused with feces inside colon.
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Lack of colon haustrations favors discrimination of colitis from feces.
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Proctitis is usually the precursor of IBD
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Descending colon thanks to its muscular tonus best shows lack of haustrations and swelling of mucosa. S. R. September 18
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Undermining of the ulcers produces some kind of tracking between them.
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Pseudo-polyp Pseudo-polyp Surrounding ulcers around normal parcels of mucosa creates pseudo-polyps. S. R. September 18
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To see the pseudo-polyps air and barium covering is necessary.
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Double contrast better delineates superficial ulcerations.
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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
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Cobble-stone appearance.
Cobble-stoning is the familiar aspect of IBD seen here in descending colon. S. R. September 18
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Negative aspect is much more suitable to show cobble-stoning and undermining
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Involvement of the left colon is much more common in IBD.
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Pan-colitis may involve whole length of the colon and is prone to malignant degeneration.
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Right colon is the last part to be involved in IBD.
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The same patient to show the incompetency of the ileo-cecal valve for later extension of inflammation. S. R. September 18
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Fairly normal pattern in the right colon.
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Rigidity of the colon in long segment is named lead-pipe sign.
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Segmental narrowing creates lead-pipe appearance.
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Lead-pipe sign in the transverse and descending colon
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Lead-pipe sign with fibrotic narrowing
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Extension of the inflammatory process to terminal ileum is called back-wash ileitis.
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Chronic ulcerative colitis with back-wash ileitis showing dilatation of the terminal ileum.
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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
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Thanks for your attention
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