Related Experiment Videos
[Ultrasound diagnosis of pseudomembranous colitis]
T Ludolph1, H A Schmidt-Wilcke
1II. Medizinische Klinik des St. Franziskus-Hospitals Münster.
Background And Objective:
The diagnosis of pseudomembranous colitis (PMC) is based on the history of exposure to antibiotics, characteristic endoscopic findings and on demonstrating the presence of Clostridium difficile toxins in the faeces. This report presents typical sonographic features of PMC.
Patients And Methods:
The sonograms of 13 patients with PMC (7 males, 6 females, median age 70 years, range 55-84 years), were retrospectively analyzed. Patients' histories, clinical findings, the results of colonoscopy including histological findings and microbiological tests were related to the sonographic features of inflammation of the colon.
Results:
At sonography the wall of the colon was thickened (6-17 mm) in each of the patients, different types of changed wall-architecture were seen. In 85% sonographic signs of colitis were restricted to the left colon, whereas in 15% a pancolitis was diagnosed. Ascites was detected in 38%, the colon contents were visible in 85%, in 77% the lumen was narrowed. Colonoscopy confirmed the diagnosis in six patients, in two patients endoscopy was performed only to control the effect of therapy and in five patients endoscopy was thought to be unnecessary.
Conclusion:
Sonography can supplement history and clinical findings if PMC is suspected. Potentially life-saving therapy can be initiated even if colonoscopy has not been performed and results of microbiological assessment are not yet available. However, the diagnosis of PMC remains to be based on the gold standard of colonoscopy and histological findings.
Insights
Ultrasound can help diagnose pseudomembranous colitis (PMC) by showing colon wall thickening and other inflammation signs. This imaging technique aids in early treatment initiation when other diagnostic methods are pending.
Area of Science:
- Gastroenterology
- Diagnostic Imaging
Background:
- Pseudomembranous colitis (PMC) diagnosis relies on antibiotic history, endoscopy, and C. difficile toxin detection.
- Sonography offers a complementary diagnostic approach.
Purpose of the Study:
- To present the typical sonographic features of pseudomembranous colitis.
- To evaluate the role of ultrasound in suspected PMC cases.
Main Methods:
- Retrospective analysis of sonograms from 13 patients diagnosed with PMC.
- Correlation of sonographic findings with clinical, endoscopic, histological, and microbiological data.
Main Results:
- Colon wall thickening (6-17 mm) observed in all patients.
- Left-sided colitis in 85%, pancolitis in 15%.
- Ascites (38%), visible colon contents (85%), narrowed lumen (77%) were noted.
Conclusions:
- Sonography can supplement clinical suspicion of PMC.
- Ultrasound may facilitate prompt therapy initiation before definitive diagnosis.
- Colonoscopy and histology remain the gold standard for PMC diagnosis.