Colonic Pseudoobstruction: CT Findings
Ji Soo Choi1,
Joon Seok Lim1,2,
Hoguen Kim3,
Jin-Young Choi1,
Myeong-Jin Kim1,
Nam Kyu Kim4 and
Ki Whang Kim1
1 Department of Diagnostic Radiology, Yonsei University Health System, Republic
of Korea.
2 Institute of Gastroenterology, Yonsei University Health System, 134
Shinchon-dong, Seodaemoon-ku, Seoul, 120-752, Republic of Korea.
3 Department of Pathology, Yonsei University Health System, Republic of
Korea.
4 Department of Surgery, Yonsei University Health System, Republic of
Korea.
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Fig. 1A —31-year-old woman with colonic pseudoobstruction. Axial
(A) and coronal (B) contrast-enhanced CT images show markedly
distended transverse colon with large amount of fecal material. Transitional
zone (arrow,A) is at splenic flexure and has no
obstructivelesions.
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Fig. 1B —31-year-old woman with colonic pseudoobstruction. Axial
(A) and coronal (B) contrast-enhanced CT images show markedly
distended transverse colon with large amount of fecal material. Transitional
zone (arrow,A) is at splenic flexure and has no obstructive
lesions.
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Fig. 1D —31-year-old woman with colonic pseudoobstruction.
Photomicrographs show ganglion cells are nearly absent in myenteric (D)
and submucosal (arrow,E) plexuses of pathologic specimen. Few
remaining ganglion cells show decrease in size and nuclei with unusual shape
(H and E, x100).
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Fig. 1E —31-year-old woman with colonic pseudoobstruction.
Photomicrographs show ganglion cells are nearly absent in myenteric (D)
and submucosal (arrow,E) plexuses of pathologic specimen. Few
remaining ganglion cells show decrease in size and nuclei with unusual shape(H
and E, x100).
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Fig. 2A —61-year-old woman with colonic pseudoobstruction. Axial CT
image shows severely distended transverse colon without obstructive lesion.
Diameter of maximally dilated colonic segment was 13.7 cm. Transitional zone
(arrow) is in splenic flexure.
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Fig. 2B —61-year-old woman with colonic pseudoobstruction. Photograph
of gross specimen shows marked dilatation of ascending and transverse colon.
Transitional zone (arrow) is in splenic flexure.
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Fig. 2D —61-year-old woman with colonic pseudoobstruction.
Photomicrograph of submucosal plexus of specimen shows reduction in number of
ganglion cells. Few remaining cells (arrows) are flattened with
abnormal shape. (H and E, x100)
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Fig. 3A —71-year-old woman with colonic pseudoobstruction and normal
findings at pathologic examination. Axial contrast-enhanced CT image obtained
when colitis was present shows relatively long segmental wall thickening with
mucosal fold thickening in transverse colon. Increased vascularity
(arrows) of marginal vessels is evident.
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Fig. 3B —71-year-old woman with colonic pseudoobstruction and normal
findings at pathologic examination. Six months afterA,patient was
hospitalized with colonic pseudoobstruction. Axial CT image shows marked
colonic distention and transitional zone (arrow) in splenic flexure.
Obstructive lesions are not present in transitional zone.
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Fig. 3C —71-year-old woman with colonic pseudoobstruction and normal
findings at pathologic examination. Photomicrograph of myenteric
(arrow) and submucosal plexuses shows ganglion cells are normal in
shape and number. (H and E, x100)
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Copyright © 2008 by the American Roentgen Ray Society.
