What is the meaning of accordion sign?
The similarity between thickened oedematous wall of pseudomembranous colitis to that of an accordion. Accordion sign arises as a result of oral contrast being trapped between oedematous haustral folds and pseudomembranes formed on the surface of the colon.
What are the differentials of accordion sign?
It has been reported to be a specific sign of severe Clostridioides difficile related colitis, it has also been described in other forms of non specific or ischaemic colitis or non-clostridial infective colitis.
What is the difference between pseudomembranous colitis and neutropenic colitis?
Neutropenic colitis (typhilitis, necrotizing enteropathy) is a life threatening right sided colitis associated with severe neutropenia, necroizing inflammation of the cecum and ascending colon associated with ischemia, pericolic fluid, inflammation and secondary bacterial invasion. Pseudomembranous colitis causes diffuse colonic involvement (pancolitis), marked colonic wall thickening with an average of 15 mm, lesser degree of pericolic fat inflammatory changes disproportionate to degree of colnonic wall thickening.
The positive contrast is seen passing through the entire bowel loops. Low attenuation marked bowel wall thickening and edema of the entire colon is seen more evident on the transverse colon with consequent encroachment upon the colonic interior lumen (luminal narrowing) and formation of crypt like appearance. The contrast is insinuated between the pseudo-membranes and swollen haustra creating an accordion sign. Noted marked ascites, pleural effusion and atropic kidneys.