Lead pipe sign in mixed inflammatory bowel disease

A middle-aged female with inflammatory bowel disease (IBD) (with mixed features of ulcerative colitis and Crohn's disease), iron deficiency anaemia and recurrent Clostridium difficile colitis presented to the emergency department with complaints of abdominal pain, haematochezia and diarrhoea. An abdominal plain film obtained during her work-up demonstrated a portion of the distal transverse, descending and sigmoid colon lacking normal haustral patterns (lead pipe sign) (figure 1, arrows). Figure 1Lead pipe sign—abdominal X-ray showing a large burden of stool throughout the colon to the descending colon where there is an ahaustral segment (arrows). Inflammation related to IBD leads to mucosal sloughing and scarring, which results in the loss of the colonic haustra. Crypt abscesses, classically described in ulcerative colitis, typically degenerate as leucocytes infiltrate the lamina propria and the epithelium breaks down. Ultimately, normal mucosal architecture is lost, and scarring shortens and...
Source: Postgraduate Medical Journal - Category: General Medicine Authors: Tags: Drugs: gastrointestinal system, GI bleeding, Inflammatory bowel disease, Emergency medicine, Journalology, Immunology (including allergy), Pain (neurology), Malnutrition, Connective tissue disease, Dermatology, Ethics, Metabolic disorders Images in medi Source Type: research