Lead pipe colon - ulcerative colitis

Case contributed by Bahman Rasuli
Diagnosis almost certain

Presentation

Chronic abdominal pain and rectal bleeding for one year.

Patient Data

Age: 25 years
Gender: Male
Fluoroscopy

Single contrast barium enema demonstrates a featureless transverse, descending, and sigmoid colon, lacking normal haustral marking appearance called lead pipe appearance. There are no stenoses or masses.

No evidence of fistula formation. 

The ascending colon appears normal with preserved normal haustral folds.

Case Discussion

Colonoscopy and biopsy revealed ulcerative colitis as inflammatory bowel disease.

The lead pipe appearance of the colon is the classical barium enema finding in chronic inflammatory bowel disease (ulcerative colitis). 

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