Colonoscopy Findings in End-Stage Liver Disease Patients with Incidental CT Colonic Wall Thickening
Eleanor L. Ormsby1,
Curtis Duffield1,
Farshad Ostovar-Sirjani2,
John P. McGahan1 and
Christoph Troppmann2
1 Department of Radiology, University of California, Davis Medical Center and
Lawrence J. Ellison Ambulatory Care Center, 4860 Y St., Ste. 3100, Sacramento,
CA 95817.
2 Department of Surgery, University of California, Davis Medical Center,
Sacramento, CA 95817.
View larger version (102K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 1A —54-year-old man with hepatitis C end-stage liver disease. CT
scan shows diffuse colonic wall thickening extending to left colon. Masslike
thickening of ascending colon (long arrow), mildly thickened
proximal transverse colon (short arrow), and loss of bowel
wall layers are seen.
|
|
View larger version (146K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 1B —54-year-old man with hepatitis C end-stage liver disease.
Colonoscopy shows increased vascularity, especially in cecum and right colon,
that is compatible with portal hypertensive colopathy.
|
|
View larger version (126K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 2A —54-year-old man with end-stage liver disease from hepatitis C
and alcoholism. Contrast-enhanced CT scan of abdomen shows markedly thickened
and edematous ascending colon, preservation of bowel wall, and stratification
of layers (long arrow). Note transverse colon is not
affected. Prominent subcutaneous vessels are seen from portosystemic
collateralization (short arrow).
|
|
View larger version (149K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 2B —54-year-old man with end-stage liver disease from hepatitis C
and alcoholism. Colonoscopy shows slightly increased chronic inflammatory
change and edema of lamina propria. Mucosa was friable and bled easily during
examination.
|
|
View larger version (122K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 3 —67-year-old woman with hepatitis C end-stage liver disease.
Contrast-enhanced CT scan of abdomen shows stratification of bowel layer
(hyperdense inner ring with relative hypodense middle layer, long
arrows). Note shaggy mucosa of transverse colon (short
arrow). Colonoscopy (not shown) showed mild mucosa edema but was
otherwise normal.
|
|
View larger version (147K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 4 —Contrastenhanced CT scan of abdomen in 43-year-old man with
end-stage liver disease from hepatitis C and alcoholism shows accordion sign
(arrow) and large nodular defects (arrowheads) that are
analogous to thumb-printing on radiographs. Colonoscopy (not shown) was normal
except for mucosal edema.
|
|
View larger version (101K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 5A —60-year-old man with colonic thickening, ulcerative colitis,
and primary sclerosing cholangitis. Contrast-enhanced CT scan of abdomen shows
diffuse concentric thickening of right and left colon. Minimal preservation of
mucosa (arrow) was seen. Note large ascites and portosystemic
collateral vessel (arrowhead).
|
|
View larger version (104K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 5B —60-year-old man with colonic thickening, ulcerative colitis,
and primary sclerosing cholangitis. CT scan of pelvis shows diffuse colonic
thickening involving rectosigmoid colon (arrow), ascites, and
mesenteric stranding. Note this colonic thickening is less in this region than
in right colon as seen in A.
|
|
View larger version (127K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 5C —60-year-old man with colonic thickening, ulcerative colitis,
and primary sclerosing cholangitis. Colonoscopy shows diffuse mucosal erythema
and superficial ulcers indicative of moderate to severe active ulcerative
colitis.
|
|
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
Copyright © 2007 by the American Roentgen Ray Society.
