36 Filling Defects in the Colon

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

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

• Fig GI 36-1 Pedunculated colonic polyp (arrows).

• Fig GI 36-2 Saddle cancer of the colon. The tumor (arrow) appears to sit on the upper margin of the distal transverse colon like a saddle on a horse.

• Fig GI 36-3 Benign villous adenoma of the rectum (arrows). Barium is seen filling the deep clefts between the multiple fronds.

Fig GI 36-4 Lipoma. Ascending colon mass that is extremely lucent and has smooth margins and a teardrop shape (arrows).

• Fig GI 36-5 Rectal carcinoid. (A) Anteroposterior and (B) lateral spot radiographs show a smoothly marginated sessile polyp (arrow) on the right lateral wall of the rectum.48

Fig GI 36-6 Carcinoma of the pancreas metastatic to the transverse colon. Shallow extrinsic pressure defect with multiple spiculations (arrow).

• Fig GI 36-7 Carcinoma of the ovary metastatic to the ascending colon (arrow). Large mass mimicking an intramural, extramucosal tumor.

• Fig GI 36-8 Lymphoma. Bulky, irregular, ulcerated mass involving much of the rectum (arrows).

• Fig GI 36-9 Familial polyposis.

• Fig GI 36-10 Carcinoma of the sigmoid (arrow) developing in a patient with long-standing familial polyposis.

• Fig GI 36-11 Gardner's syndrome. Innumerable adenomatous polyps throughout the colon present a radiographic appearance indistinguishable from that of familial polyposis.

Fig GI 36-12 Inflammatory pseudopolyposis in Crohn's colitis.

• Fig GI 36-13 Fecal impaction.

• Fig GI 36-14 Endometriosis. Three separate endometrial implants (arrows and arrowheads) in the sigmoid colon. The most distal lesion has a smooth interface with the bowel wall, indicating no intramural invasion. The two more proximal lesions demonstrate crenulations indicating intramural or submucosal invasion.49

• Fig GI 36-15 Intussusception. Obstruction of the colon at the hepatic flexure. Note the characteristic coiled-spring appearance.

• Fig GI 36-16 Internal hemorrhoids. Multiple rectal filling defects (arrows) simulate polyps.

• Fig GI 36-17 Nodular lymphoid hyperplasia. The arrows point to characteristic flecks of barium in the centers of several of the lymphoid masses.

• Fig GI 36-18 Lymphoid follicular pattern in an adult.50

• Fig GI 36-19 Colonic urticaria. Large polygonal, raised plaques in a dilated cecum and ascending colon.