Diagnostic Ultrasound - Abdomen and Pelvis

Bowel Wall Thickening
Clostridium Difficile Colitis
Clostridium Difficile Colitis
(Left) Oblique sagittal US in
right flank demonstrates
markedly thickened ascending
colon due to clostridium
difficile colitis. Note the
marked submucosal layer
edema ſt and pronounced
haustral pattern st, giving
rise to the accordion sign.
(Right) Corresponding CECT
reflects the described
ultrasound findings. The
colonic wall is markedly
thickened ſt; this is typically a
pancolitis. Ascites is usually
present.
Differential Diagnoses: Bowel
Mural Hemorrhage
Mural Hemorrhage
(Left) Longitudinal US of the
small bowel shows
homogeneous hypoechoic
symmetric thickening ſt and
luminal narrowing . The
mural stratification is almost
lost in this case, appearances
representing intramural
hemorrhage in a patient with
Henoch-Schönlein purpura.
(Right) Axial US of the same
segment shows the
symmetrical circumferential
thickening ſt with loss of the
mural stratification.
Deep Infiltrative Endometriosis
Deep Infiltrative Endometriosis
(Left) Sagittal transvaginal US
shows deep infiltrative
endometriosis ſt in the
posterior compartment of the
pelvic cul-de-sac. Note the
focal eccentric thickening of
anterior rectosigmoid wall
from endometriosis infiltration
and widening of the
muscularis propria layer .
The uterus is noted. (Right)
Corresponding MR shows the
focal anterior rectosigmoid
wall thickening ſt from
infiltration and the edematous
overlying mucosa giving the
mushroom cap sign . The
uterus is noted.
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