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Daily Case Vignette - CTisus.com — Colon. Machine-transcribed; use the interactive transcript above to jump the player to any line.
In this patient with GI bleed, the likely diagnosis is, well, what do I see here? Remember, we only have one phase because I'm only giving you two images, but there's high density in the patient's sigmoid colon descending colon junction. You can see it on the axial, as well as on the coronal view, and what this represents is the side of active bleeding. It could be colon cancer that can bleed, but I don't see a real mess. It doesn't look like a schema colitis. There's no bowel wall thickening. A schema colitis is typically not associated with bleeding. Anyway, pseudo-memorous colitis, the bowel wall would be much thicker. The average wall thickening in pseudo-memorous colitis is 1.1 centimeters, and usually with pseudo-memorous colitis, the involvement is a larger area. If you look carefully at this bowel, there are some diverticuli present,
and so what this likely represents is one of the number one courses of bleeding in the colon, evidence of diverticulitis with active bleeding. Most patients with diverticulitis will have one active bleed, and they will not have a second bleed, so most of these patients at the end of the day will be treated conservatively.
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