PMC9951622_01
Barium enema - reduced caliber and irregular contour of the lumen of the colon, with thumbprinting. The sigmoid colon was relatively spared.
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F1
Barium enema (Figure 1), abdominal ultrasound with color Doppler (Figure 2), and contrast-enhanced computed tomography (CT) with water enema were performed (Figure 3).
Abdominal ultrasound - diffuse parietal thickening of the colon, with increased vascularization on color Doppler evaluation. The mesentery at the right upper quadrant (b) was also thickened and showed increased vascularization.
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F2
Barium enema (Figure 1), abdominal ultrasound with color Doppler (Figure 2), and contrast-enhanced computed tomography (CT) with water enema were performed (Figure 3).
Abdominal CT images - a) axial pre-contrast; b) axial arterial phase; c) axial portal phase; d) coronal MIP arterial phase; e) coronal MIP portal phase; f) axial arterial phase at the level of the portal vein - showed high-density material in the rectum consistent with blood (dashed circle in a) and thickening of the colon wall with intense globular mural enhancement and diffuse filling (arrows in b and c). The mesentery of the right quadrants was also thickened and enhancing, and a small mesenteric phlebolith (dashed arrow in c) was seen. MIP images showed tapering of the aorta at the level of the superior mesenteric artery (faded lines in d) and enlargement of the superior mesenteric artery and vein (star in e). The portal vein was also enlarged and showed avid enhancement in the arterial phase (arrow in f).
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F3
Barium enema (Figure 1), abdominal ultrasound with color Doppler (Figure 2), and contrast-enhanced computed tomography (CT) with water enema were performed (Figure 3).
Abdominal CT image of the abdomen (arterial phase) 12 months after treatment with propranolol showed almost complete regression of the bowel wall thickening, with slight arterial phase hyperenhancement on the cecal wall as the only finding.
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F4
Repeat CT showed regression of the findings (Figure 4), confirmed at endoscopy.