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Large bowel obstruction caused by sclerosing peritonitis: contrast-enhanced CT findings

Department of Radiology, Soonchunhyang University Hospital, 657 Hannam-Dong, Youngsan-Ku, Seoul 140-743, Korea

View larger version (117K): [in a new window]   Figure 1. Plain erect abdominal radiography revealed dilatation of the ascending colon with a large amount of faecal material (arrowheads) and multiple air-fluid levels in the small bowel loops.

View larger version (120K): [in a new window]   Figure 2. Contrast-enhanced CT shows a marked dilatation with faecal material in the ascending colon caused by stricture of the proximal transverse colon (arrows). Mesenteric vascular engorgement and a small amount of peritoneal fluid were also demonstrated. However, there were no peritoneal changes such as enhancement, fibrosis or calcification. The left kidney shows atrophy with calcifications.

View larger version (128K): [in a new window]   Figure 3. (a) On pathology, the colon shows a markedly thickened and fibrous serosal membrane (S) and disappearance of the outer longitudinal muscle layer (haematoxylin–eosin stain x 40). (b) On special stain for fibrous tissue, the colon shows a markedly thickened and fibrous serosal membrane (S) (Masson-trichrom stain x 40).