Ulcerative colitis - Thumbprinting

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Ulcerative colitis - Thumbprinting

  • Abdominal X-rays are often entirely normal in inflammatory bowel disease. Occasionally there are signs of acute inflammation indicated by bowel wall thickening.
  • This image demonstrates extensive bowel wall thickening throughout the entire colon. Thickening of the haustral folds results in a 'thumbprinting' appearance (arrowheads).

Ulcerative colitis - Mucosal islands

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Ulcerative colitis - Mucosal islands

  • This patient with known ulcerative colitis has 'mucosal islands' - or pseudopolyps - in the caecum.
  • In ulcerative colitis, bowel wall inflammation extends proximally from the rectum. This X-ray therefore suggests that inflammation affects the whole colon.
  • The large bowel is not visible more distally, because it does not contain gas.

Ulcerative colitis - Toxic megacolon

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Ulcerative colitis - Toxic megacolon

  • This patient's colon is very dilated and there are extensive 'mucosal islands' indicating bowel wall inflammation.