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Thumbprinting - ulcerative colitis

Case contributed by Ian Bickle
Diagnosis almost certain

Presentation

New diagnosis of ulcerative colitis. Worsening abdominal pain.

Patient Data

Age: 17 years
Gender: Male

Nodular indentations of an otherwise relatively featureless ascending and transverse colon.  The appearance is consistent with 'thumbprinting'.

The distal colon is not illustrated.

Normal small bowel.  No pneumoperitoneum.

Case Discussion

Thumbprinting is the term used for the plain radiograph appearance of colitis.  It is most commonly observed in ulcerative colitis as was the diagnosis in this young patient.

It is a thumb (or nodular) shaped indentation of the colon which is thickened with mucosal edema. The bowel is often also featureless.

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