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Imaging Features of Enterohemorrhagic Escherichia coli Colitis

¹ Department of Radiology, Northwestern Memorial Hospital, Northwestern University Medical School, 676 N. St. Clair St., Ste. 800, Chicago, IL 60611.
² University of Illinois College of Medicine, 1740 W. Taylor St., Chicago, IL 60612.
³ Lahey Clinic, Medical Center, 41 Mall Rd., Burlington, MA 01805.

View larger version (112K): [in a new window]   Fig. 1A. —53-year-old febrile man with diarrhea and lower abdominal pain of 2 days' duration. Patient had bloody and mucous stools of 24-hr duration. Contrast-enhanced CT scan shows pancolitis with thickened ascending colon and descending colon with target sign (solid arrows). Note pericolonic inflammatory changes (open arrows).

View larger version (153K): [in a new window]   Fig. 1B. —53-year-old febrile man with diarrhea and lower abdominal pain of 2 days' duration. Patient had bloody and mucous stools of 24-hr duration. CT scan reveals sigmoid colon (solid arrow) as less thickened than rest of colon. Note pelvic fluid (open arrow). After CT examination, patient remembered having eaten a largely uncooked meal several days before admission.

View larger version (146K): [in a new window]   Fig. 2A. —63-year-old woman with bloody diarrhea of 3 days' duration and suspected bowel obstruction. Conventional radiograph shows thumbprinting in transverse colon (arrows).

View larger version (117K): [in a new window]   Fig. 2B. —63-year-old woman with bloody diarrhea of 3 days' duration and suspected bowel obstruction. Contrast-enhanced CT scan shows bowel wall thickening involving ascending (open arrow), transverse (solid straight arrow), and descending colons with pericolonic inflammation (curved arrows). Note target sign of wall of ascending colon (open arrow).

View larger version (126K): [in a new window]   Fig. 3. —54-year-old afebrile woman presented with abdominal pain and bloody diarrhea. CT scan shows thickened colon with target sign (solid arrows) predominately involving ascending and transverse colons. Note pericolonic inflammatory changes (open arrow).

View larger version (145K): [in a new window]   Fig. 4. —21-year-old afebrile man with history of gastroesophageal reflux and dull right lower quadrant pain. He was suspected to have appendicitis. Contrast-enhanced CT scan shows inflammation of cecum (curved solid arrow) and terminal ileum (straight solid arrow) without evidence of appendicitis. Note pericolonic inflammatory changes (open arrow). CT findings are similar to typhlitis. Patient had eaten Chinese food before symptoms and Escherichia coli colitis developed.

View larger version (141K): [in a new window]   Fig. 5. —11-year-old boy with diarrhea and bloody stool. Single-contrast barium enema shows thumbprinting suggesting submucosal edema involving the cecum (solid arrows) and transverse colon (open arrows).

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