GI Radiology > Colon > Infectious Diseases > Psuedomembranous Colitis

Infectious Diseases

Pseudomembranous Colitis

Pseudomembranous Colitis is caused by overgrowth of Clostridium difficile and is characterized by a pseudomembrane of necrotic debris in the colon, diarrhea, foul stools, abdominal cramps, nausea and vomiting. Antibiotic use, intestinal ischemia, obstruction, irradiation, shock, and long-term steroids may trigger this disease. Diagnosis is made by detection of C. difficile toxin in a stool sample and treatment is with Metronidazole or Vancomycin. Plain films will show a dilated colon, ascites, and a nodular thickening of the haustra. Barium studies will demonstrate an irregular lumen, thumbprint indentations, and superficial ulcers. CT will reveal wall thickening (~15cm) with a target-like appearance, pericolic fat inflammation, ascites, and the "accordion sign" with stripes of intraluminal contrast trapped between the nodular, hypertrophied wall.

Thumbprinting (arrow) and colonic dilation on plain film in Pseudomembranous Colitis

 

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