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Case 97

Pseudomembranous colitis

Findings

CT Findings

• No obvious collection.
• Smooth circumferential thickening of large bowel (particularly caecum, ascending colon and sigmoid colon).
• Target appearance due to enhancing mucosa and oedematous submucosa.
• Pericolic stranding.

Diagnosis

Pseudomembranous colitis

Discussion

Although some of the changes seen could be secondary to recent surgery, the diffuse large bowel thickening was thought more typical of a colitis. The entire colon was involved (other images not shown). As the patient had antibiotics post-peratively Pseudomembranous colitis was suggested. The presence of Clostridium difficile toxin was confirmed. Ulcerative colitis may have a similar appearance.

References

There is an excellent online poster (in .pdf format) discussing the CT appearances of various colitides at www.massgeneralimaging.org/REMS_Site/work_examples/ posters.pdf/poster1.pdf.

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