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Related Experiment Videos

Pseudomembranous colitis with rectosigmoid sparing on barium studies.

S E Rubesin1, M S Levine, S N Glick

  • 1Department of Radiology, Hospital of the University of Pennsylvania, PA 19104.

Radiology
|March 1, 1989
PubMed
Summary

Pseudomembranous colitis can present atypically on barium studies, showing rectosigmoid sparing. This finding, with proximal colitis, aids diagnosis when endoscopy is inconclusive for this condition.

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Area of Science:

  • Gastroenterology
  • Radiology
  • Internal Medicine

Background:

  • Pseudomembranous colitis classically shows pancolitis on barium enema.
  • Typical findings include thickened folds, shaggy contour, and mucosal plaques.

Purpose of the Study:

  • To describe an atypical presentation of pseudomembranous colitis on barium studies.
  • To highlight cases with rectosigmoid sparing and proximal colitis.

Main Methods:

  • Retrospective review of six patients with confirmed pseudomembranous colitis.
  • Analysis of barium studies (double-contrast, single-contrast, peroral pneumocolon) and endoscopic findings.

Main Results:

  • Six patients showed pseudomembranous colitis with rectosigmoid sparing.

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  • Proximal colitis extended to the sigmoid or descending colon.
  • Endoscopy revealed normal or mildly inflamed rectosigmoid without pseudomembranes.
  • Four patients had atypical clinical presentations, including bloody diarrhea.

    • Conclusions:

    • Barium studies may suggest pseudomembranous colitis with relative rectosigmoid sparing.
    • Proximal colonic findings are key in these atypical cases.
    • This presentation can aid diagnosis when endoscopy is non-specific.