What causes lead-pipe colon in the large bowel on barium enema?
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Answer:
Chronic ulcerative colitis results in the lead-pipe colon sign, characterized by a featureless, smooth, tubular, and often shortened colon with complete loss of haustral markings on barium enema, CT, MRI, or plain radiography.
Why is it called so?
The sign is named for the rigid, smooth, cylindrical appearance of the colon resembling the uniform, featureless exterior of a lead pipe.
Pathophysiology
Repeated cycles of inflammation in chronic ulcerative colitis lead to mucosal ulceration, fibrosis, and muscularis mucosa hypertrophy, which obliterate haustra and cause uniform bowel wall thickening with luminal narrowing, producing a rigid, non-distensible tubular contour.
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