CLINICAL IMAGAGING AN ATLAS OF DIFFERENTIAL DAIGNOSIS EISENBERG

1. 36Filling Defects in the Colon

2. CLINICAL IMAGAGING
AN ATLAS OF DIFFERENTIAL DAIGNOSIS
EISENBERG
DR. Muhammad Bin Zulfiqar
PGR-FCPS III SIMS/SHL

3. • Fig GI 36-1 Pedunculated colonic polyp
(arrows).

4. • Fig GI 36-2 Saddle cancer of the colon. The
tumor (arrow) appears to sit on the upper
margin of the distal transverse colon like a
saddle on a horse.

5. • Fig GI 36-3 Benign villous adenoma of the
rectum (arrows). Barium is seen filling the
deep clefts between the multiple fronds.

6. Fig GI 36-4 Lipoma. Ascending colon mass that is extremely
lucent and has smooth margins and a teardrop shape (arrows).

7. • Fig GI 36-5 Rectal carcinoid. (A)
Anteroposterior and (B) lateral spot
radiographs show a smoothly marginated
sessile polyp (arrow) on the right lateral wall
of the rectum.48

8. Fig GI 36-6 Carcinoma of the pancreas metastatic to the transverse
colon. Shallow extrinsic pressure defect with multiple spiculations
(arrow).

9. • Fig GI 36-7 Carcinoma of the ovary metastatic
to the ascending colon (arrow). Large mass
mimicking an intramural, extramucosal tumor.

10. • Fig GI 36-8 Lymphoma. Bulky, irregular,
ulcerated mass involving much of the rectum
(arrows).

11. • Fig GI 36-9 Familial polyposis.

12. • Fig GI 36-10 Carcinoma of the sigmoid (arrow)
developing in a patient with long-standing
familial polyposis.

13. • Fig GI 36-11 Gardner's syndrome.
Innumerable adenomatous polyps throughout
the colon present a radiographic appearance
indistinguishable from that of familial
polyposis.

14. Fig GI 36-12 Inflammatory pseudopolyposis in Crohn's colitis.

15. • Fig GI 36-13 Fecal impaction.

16. • Fig GI 36-14 Endometriosis. Three separate
endometrial implants (arrows and arrowheads) in
the sigmoid colon. The most distal lesion has a
smooth interface with the bowel wall, indicating
no intramural invasion. The two more proximal
lesions demonstrate crenulations indicating
intramural or submucosal invasion.49

17. • Fig GI 36-15 Intussusception. Obstruction of
the colon at the hepatic flexure. Note the
characteristic coiled-spring appearance.

18. • Fig GI 36-16 Internal hemorrhoids. Multiple
rectal filling defects (arrows) simulate polyps.

19. • Fig GI 36-17 Nodular lymphoid hyperplasia. The
arrows point to characteristic flecks of barium in
the centers of several of the lymphoid masses.

20. • Fig GI 36-18 Lymphoid follicular pattern in an
adult.50

21. • Fig GI 36-19 Colonic urticaria. Large polygonal,
raised plaques in a dilated cecum and
ascending colon.