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Pseudomembranous colitis: CT evaluation of 26 cases
E K Fishman1, M Kavuru, B Jones
1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD.
Abstract:
Pseudomembranous colitis (PMC) is an infectious colitis usually occurring as a complication of antibiotic use. The computed tomographic (CT) appearances of 26 patients with PMC were reviewed. Twenty-three patients demonstrated an abnormal bowel wall, with an average wall thickness of 14.7 mm (range, 3-32 mm); in three patients, bowel wall thickness was normal. Contrast material trapped between thickened folds corresponded to the broad transverse bands described on plain radiographs. Pancolonic involvement was seen in 13 cases, while seven patients had right-sided involvement only; three patients had bowel wall thickening limited to the rectosigmoid only. Although the CT appearance of PMC is not highly specific, the diagnosis may be suggested in the proper clinical setting.
Insights
Computed tomographic (CT) scans can help diagnose pseudomembranous colitis (PMC), an antibiotic-associated condition. While not definitive, CT findings like thickened bowel walls suggest PMC in patients with relevant symptoms.
Area of Science:
- Gastroenterology
- Radiology
- Infectious Diseases
Background:
- Pseudomembranous colitis (PMC) is an infectious colitis often linked to antibiotic use.
- Accurate and timely diagnosis is crucial for effective patient management.
Purpose of the Study:
- To evaluate the computed tomographic (CT) imaging features of pseudomembranous colitis (PMC).
- To determine the diagnostic utility of CT in identifying PMC.
Main Methods:
- Retrospective review of CT scans from 26 patients diagnosed with PMC.
- Analysis of bowel wall thickness, distribution of involvement, and characteristic imaging findings.
Main Results:
- Twenty-three of 26 patients exhibited abnormal bowel wall thickening, averaging 14.7 mm.
- Contrast material trapped between folds mimicked transverse bands seen on radiographs.
- Pancolonic involvement occurred in 13 cases; others showed right-sided or rectosigmoid-limited thickening.
Conclusions:
- CT imaging can suggest a diagnosis of pseudomembranous colitis (PMC) in the appropriate clinical context.
- Key CT findings include bowel wall thickening and characteristic band-like appearances.
- While not entirely specific, CT plays a supportive role in diagnosing PMC.