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- W4312113880 abstract "A 35-year-old man presented with left side abdominal cramps and bloody stools that persisted for 1 week. Physical examination revealed a body temperature of 38.5 °C (101.3 °F), normoactive bowel sounds, and left lower quadrant tenderness. A standing abdominal radiograph showed a nonspecific small bowel gas pattern and a smooth radiolucent descending colon without haustration (Figure 1), indicating a typical lead pipe sign. Ultrasonography of the left side of the abdomen revealed a straight, smooth-walled descending colon filled with blood-like heterogeneous echogenic materials (Figure 2 and Video E1). This “sonographic lead pipe sign” confirmed the loss of haustration in the descending colon. Colofibroscopy confirmed the diagnosis.Figure 2Ultrasonography of the left side abdomen acquired at the mid-axillary line in a coronal view revealed a straight, smooth-walled descending colon filled with blood-like heterogeneous echogenic materials (the asterisk indicates the kidney, and the white arrow indicates the colon).View Large Image Figure ViewerDownload Hi-res image Download (PPT) Ulcerative colitis. The patient underwent colofibroscopy, which revealed multiple irregular-shaped ulcers, with hyperemic mucosa at the descending colon (Figure 3). Histopathology of an endoscopic biopsy specimen revealed infiltration of neutrophils at surface epithelium, with mucosal ulceration and crypt architectural distortion. The patient’s condition improved under mesalazine treatment with follow-up in the gastroenterology clinics. The lead pipe appearance of the colon is classically seen with chronic ulcerative colitis.1Fonseca E.K.U.N. Yamauchi F.I. Moron R.A. Baroni R.H. Lead pipe sign in ulcerative colitis.Abdom Radiol (NY). 2018; 43: 1502-1503Crossref Scopus (3) Google Scholar,2Ekeledo O.J. Scelsi C. Keshavamurthy J.H. Lead pipe sign in mixed inflammatory bowel disease.Postgrad Med J. 2017; 93: 368Crossref Scopus (2) Google Scholar The lead pipe sign is a classical barium enema finding and is also remarkable in the plain radiograph. In suspicious abdominal radiographs, point-of-care ultrasound may facilitate diagnosis by identifying the loss of normal haustration in the affected colon. To curb the overuse of computed tomography in patients with inflammatory bowel disease, this “sonographic lead pipe sign” can be an option for imaging patients with inflammatory bowel disease in the emergency department.3Griffey R.T. Fowler K.J. Theilen A. Gutierrez A. Considerations in imaging among emergency department patients with inflammatory bowel disease.Ann Emerg Med. 2017; 69: 587-599Abstract Full Text Full Text PDF PubMed Scopus (14) Google Scholar eyJraWQiOiI4ZjUxYWNhY2IzYjhiNjNlNzFlYmIzYWFmYTU5NmZmYyIsImFsZyI6IlJTMjU2In0.eyJzdWIiOiJhZWU3OWFjNDY1ZDYyNGE3NGRiMmMzYmY5YWU1NTljMSIsImtpZCI6IjhmNTFhY2FjYjNiOGI2M2U3MWViYjNhYWZhNTk2ZmZjIiwiZXhwIjoxNjkxNTMyMzU2fQ.c1D18KTpnR0JAEKvqvEnV7MLxd1TmqxlsWVMIEtkuJMLVCYS7L9pbTjbBgdri0aTL0hDazC2dB4spaTo2pAdlu8eWUahlI8yZ43r9FmEEdFjx9M4dM0rlPgxx-d1JMN9P1Fpjb0QyKvujopFbJdcjXO-Vy9IVF0kd-ri2m1JrBIqXK2dfLIcMtXAFymIKoh1-7RBZJwTIhTwqZxbajKnLkMLuF81QLM3kGGN0hkwwC1VFbNG85xkKio_quMYW_rp2ZNbBOa8FAfZYINfHIL8E0mIuozQqzRMxEzUdYy8IspMkNcCxRKeGBtkgcQbTHyxP9UQVUZUtan1nOSLplr2sA Download .mp4 (2.09 MB) Help with .mp4 files Video 1Ultrasonography of the left abdomen in a coronal view revealed a straight, smooth-walled descending colon filled with heterogenous echogenic materials. Tracing the descending colon from the right kidney level to the left lower quadrant presented a “sonographic lead pipe appearance” of the descending colon." @default.
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- W4312113880 date "2023-01-01" @default.
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- W4312113880 title "Young Man With Abdominal Cramps and Bloody Stools" @default.
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- W4312113880 doi "https://doi.org/10.1016/j.annemergmed.2022.06.024" @default.
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