Pseudoulcerations of the colon on barium enema examination

Marginal spiculations and punctate collection of barium may occasionally be identified on barium examination in patients with a normal colon. These may be due either to filling of the crypts of Lieberkuhn with barium or retention of barium in the innominate grooves of the colon. Perhaps both combine to produce the radiographic findings. This normal variant must be carefully distinguished from actual ulcers associated with inflammatory bowel disease in order to avoid making a major error in diagnosis.