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Double tracking in the sigmoid colon

J T Ferrucci, B D Ragsdale, P J Barrett

    Radiology
    |August 1, 1976
    PubMed
    Summary
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    Double barium tracking in the sigmoid colon is often linked to diverticulitis, not granulomatous colitis. This study found diverticulitis in most cases, with rare instances of perforated carcinoma, suggesting barium tracking is a sign of diverticular disease.

    Area of Science:

    • Gastroenterology
    • Radiology
    • Pathology

    Background:

    • Double tracking of barium in the sigmoid colon is a radiological finding with debated clinical significance.
    • It has been associated with both granulomatous colitis and diverticulitis.

    Purpose of the Study:

    • To investigate the pathological basis of double barium tracking in the sigmoid colon.
    • To differentiate between granulomatous colitis and diverticulitis as causes of this finding.

    Main Methods:

    • Analysis of patients with double barium tracking and no other signs of large intestine inflammatory disease.
    • Pathological examination of resected specimens.

    Main Results:

    • Diverticulitis was the pathological diagnosis in 29 out of 35 cases.

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  • Granulomatous diverticulitis was diagnosed in only one case.
  • Perforated sigmoid colon carcinoma was the underlying cause in 5 cases.
  • Paracolic sinus tracts in diverticulitis were extrinsic to the muscularis and linked to perforated diverticula.

    • Conclusions:

    • Double barium tracking in the sigmoid colon is predominantly a sign of diverticulitis.
    • It is not typically associated with subsequent inflammatory bowel disease.