Different Aspects of ColitisAs Shown in

Barium Studies

S. Rad

With Selected Cases From His Own Teaching Files

Tabriz University of Medical Sciences

Tabriz-Iran

Apr 8, 20231 S. R.

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.

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.

Apr 8, 20232 S. R.

Circular collar-button ulcers are usually found in preliminary Circular collar-button ulcers are usually found in preliminary statesstates..

Collar-button ulcer

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Wide spread tiny ulcerations are sometimes confused with feces Wide spread tiny ulcerations are sometimes confused with feces inside coloninside colon..

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Lack of colon haustrations favors discrimination of colitis from Lack of colon haustrations favors discrimination of colitis from fecesfeces..

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Proctitis is Proctitis is usually the usually the

precursor of precursor of IBDIBD

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Descending colon thanks to its muscular tonus best Descending colon thanks to its muscular tonus best shows lack of haustrations and swelling of mucosashows lack of haustrations and swelling of mucosa..

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L

Undermining of the Undermining of the ulcers produces ulcers produces

some kind of some kind of tracking between tracking between

themthem..

Undermining

Undermining

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Surrounding ulcers around normal parcels of mucosa creates Surrounding ulcers around normal parcels of mucosa creates pseudo-polypspseudo-polyps..

Pseudo-polyp

Pseudo-polyp

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Pseudo-polyps

To see the pseudo-polyps air and barium covering is necessaryTo see the pseudo-polyps air and barium covering is necessary..

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Double contrast better delineates superficial ulcerationsDouble contrast better delineates superficial ulcerations..

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Different episodes of IBD may be seen in one filmDifferent episodes of IBD may be seen in one film..

Active phase

Fibrotic narrowing in

chronic phase

Toxic mega-colon

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Cobble-stoning is the Cobble-stoning is the familiar aspect of IBD familiar aspect of IBD

seen here in seen here in descending colondescending colon..

Cobble-stone

appearance.

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Negative aspect is much Negative aspect is much more suitable to show cobble-more suitable to show cobble-stoning and underminingstoning and undermining

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Involvement of the left colon is much more common in IBDInvolvement of the left colon is much more common in IBD..

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Pan-colitis may involve whole Pan-colitis may involve whole length of the colon and is length of the colon and is

prone to malignant prone to malignant degenerationdegeneration.. Apr 8, 202316 S. R.

Right colon is the last part to be involved in IBDRight colon is the last part to be involved in IBD..

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The same The same patient to patient to show the show the

incompetency incompetency of the ileo-of the ileo-

cecal valve cecal valve for later for later

extension of extension of inflammationinflammation..

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Fairly normal pattern in the right colonFairly normal pattern in the right colon..

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Rigidity of the colon in long segment is named lead-pipe signRigidity of the colon in long segment is named lead-pipe sign..Apr 8, 202320 S. R.

Segmental narrowing creates lead-pipe appearanceSegmental narrowing creates lead-pipe appearance..

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Lead-pipe sign in the transverse and descending colonLead-pipe sign in the transverse and descending colon

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Lead-pipe sign with fibrotic narrowingLead-pipe sign with fibrotic narrowing

Fibrotic narrowing

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Extension of the inflammatory process to terminal ileum is Extension of the inflammatory process to terminal ileum is called back-wash ileitiscalled back-wash ileitis..

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Chronic ulcerative Chronic ulcerative colitiscolitis with back-wash ileitis with back-wash ileitis showing dilatation of the terminal ileumshowing 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 .

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 .

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Thanks for your attentionThanks for your attention

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