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Related Experiment Videos

CT findings in isolated ischemic proctosigmoiditis.

Walter Wiesner1, Koenraad J Mortelé, Jonathan N Glickman

  • 1Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. wwiesner@uhbs.ch

European Radiology
|July 12, 2002
PubMed
Summary

Computed tomography (CT) can identify ischemic proctosigmoiditis, often mimicking diverticulitis. Key CT findings include rectal and sigmoid wall thickening with fat stranding, crucial for diagnosis in at-risk patients.

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Area of Science:

  • Radiology
  • Gastroenterology
  • Pathology

Background:

  • Ischemic proctosigmoiditis presents with non-specific symptoms.
  • Accurate diagnosis is essential, especially in elderly patients or those with cardiovascular risk factors.
  • Distinguishing from other conditions like diverticulitis can be challenging.

Purpose of the Study:

  • To describe computed tomography (CT) features of ischemic proctosigmoiditis.
  • To correlate CT findings with clinical, laboratory, endoscopic, and histopathologic data.
  • To evaluate the diagnostic accuracy of CT in identifying this condition.

Main Methods:

  • Retrospective review of seven patients with isolated ischemic proctosigmoiditis.
  • Analysis of colonoscopic biopsies and histopathologic records over 4 years.

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  • Consensus review of CT examinations, comparing findings with clinical and histopathologic results.

    • Main Results:

    • All seven patients showed CT evidence of wall thickening confined to the rectum and sigmoid colon.
    • Pararectal fat stranding was observed in four patients; perisigmoidal fat stranding in one.
    • Five patients had coexistent diverticulosis, leading to initial misinterpretation as diverticulitis in three cases.

    Conclusions:

    • Isolated ischemic proctosigmoiditis can exhibit unspecific CT features and misleading clinical findings.
    • CT findings of rectal and sigmoid wall thickening with perirectal fat stranding are suggestive of ischemic proctosigmoiditis.
    • Consideration of ischemic proctosigmoiditis is vital in elderly patients or those with cardiovascular risk factors presenting with these CT findings.