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Colorectal Trauma

KEY FACTS Terminology Blunt or penetrating injury to rectum or colon Imaging Transverse and descending colon are most common sites for blunt traumatic injury Rectum is most common site for penetrating injury Best diagnostic clue Colonic wall thickening with adjacent mesenteric hemorrhage or ectopic gas Best imaging tool: CECT with multiplanar reformations Rectal and intravenous contrast for penetrating injuries CT signs Discontinuity or thickening of colonic…

Enteric Fistulas and Sinus Tracts

KEY FACTS Terminology Enteric fistula : Abnormal connection between bowel and another epithelial-lined surface (e.g., bladder, vagina, skin) Enteric sinus tract : Blind-ending tract originating from bowel Imaging Fluoroscopy Fistulogram: Best modality for enterocutaneous fistulas Small bowel follow-through : Complementary to CT or MR enterography for Crohn's disease Contrast enema : Often definitive for colonic fistulas (to bladder, vagina, etc.) CT: Primary or complementary role Definitive…

Colonic Ileus and Ogilvie Syndrome

KEY FACTS Terminology Ogilvie syndrome, colonic pseudoobstruction, adynamic ileus, functional obstruction Acute: Reversible, occurring with severe medical illness and major surgeries Chronic: Constipation, no etiology for ileus, and repeated obstructive symptoms You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Cecal Volvulus

KEY FACTS Terminology Cecal volvulus : Rotational twist of right colon on its axis, resulting in progressive distention and potential ischemia Cecal bascule Cecum is distended and lumen narrowed by medial folding and displacement, without twist You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Sigmoid Volvulus

KEY FACTS Terminology Torsion or twisting of sigmoid colon around its mesenteric axis, resulting in progressive dilation & possible perforation You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Epiploic Appendagitis

KEY FACTS Terminology Acute inflammation or infarction of epiploic appendages (EA, fat-filled serosal outpouchings on colonic surface) You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Neutropenic Enterocolitis (Typhlitis)

KEY FACTS Terminology Life-threatening, necrotizing enterocolitis occurring primarily in severely neutropenic patients Imaging Best imaging tool: CECT with multiplanar reformations Massive mural thickening of cecal ± ascending colon wall – Other segments of colon and small bowel can be affected Mucosal hyperenhancement and submucosal edema (marked) Infiltration of pericolonic fat Less common, more severe findings Pneumatosis, extraluminal gas and fluid (perforation) Top Differential Diagnoses Pseudomembranous colitis…

Infectious Colitis

KEY FACTS Terminology Colonic inflammation due to bacterial, viral, fungal, or parasitic infections Imaging Best imaging tool: CECT with multiplanar reformations Mucosal hyperenhancement, marked submucosal edema, ascites Multiple air-fluid levels, inflamed pericolonic fat Ultrasound findings Symmetric wall thickening and submucosal echogenicity Increased mural flow on color Doppler Fluoroscopic findings Used less frequently than before; now supplanted by CT, US, and endoscopy Clostridium difficile , Campylobacter ,…

Colon: Imaging Approach and Differential Diagnosis

Embryology and Congenital Malformations The ascending and transverse colon, along with the small intestine, are part of the embryologic midgut, which undergoes marked elongation beginning in the 6th week of fetal development. To accommodate this increased length, the midgut herniates into the base of the umbilical cord. During the 10th week, it returns to the abdomen while undergoing a complex series of rotations and fixations. All…

Hamartomatous Polyposis Syndromes

KEY FACTS Terminology Spectrum of hereditary and nonhereditary polyposis syndromes characterized by gastrointestinal (GI) tract polyps and other associated lesions Imaging CT enterography is best imaging tool (multiplanar, contrast enhanced) Best diagnostic clue Cluster of small filling defects in small bowel (SB) with intussusception Peutz-Jeghers syndrome (PJS) Polyps in jejunum and ileum > duodenum > colon > stomach Top Differential Diagnoses Familial adenomatous polyposis and related…