INTEGRATED ROENTGEN SIGNS OF ABNORMALITY OF THE COLON AS MANIFEST IN SPECIFIC DISEASES

887

INCLUDEPICTURE "../../../SHAKT I~1/AppData/Loc al/Temp/FineRea der11.00/media/ image1.jpeg" \* MERGEFORMAT

INTEGRATED ROENTGEN SIGNS OF ABNORMALITY OF THE COLON AS MANIFEST IN SPECIFIC DISEASES

887

Figure 8-77. Feces defects in the colon.

producing

innumerable

filling

Colonic Atresia
Atresia of the large intestine is far less frequent than that of the small intestine, and it probably occurs in no more than one in 40,000 live births (Franken). There are three types of colonic atresia. In type 1, there is occlusion of the colon by * web or diaphragm (Blank et al). This may be associated with a windsock sign, which is very much like the intraluminal diverticulum appearance of the duodenum. Basically, the web or diaphragm is displaced proximally and somewhat rotated, and peristalsis pushes the intestinal contents against the membrane, stretching the colon and producing the appearance of an intraluminal diverticulum. In type 2, there is an atretic cord in the colon with a proximal and distal colon; and in tjf>e 3, there is a complete separation of the proximal and distal colon with an associated mesenteric delect. Generally, in types 1 and 2 there is an abrupt nondistorted termination of the retrograde flow at the anatomic level of the obstruction rather than the windsock appearance previously described (Selke and Jona). In type 3 atresia, usually there is a characteristic hooking of the colon proximal to where retrograde flow is halted. This hook is caused by a recoiling of the proximal portion of the distal

3. 4.

Hemicolectomy, proximal Gastrocolic fistulae

Integrated Roentgen Signs of Abnormality of the Colon as Manifest in Specific Diseases

SPECIFIC COLONIC DISEASES IN THE PEDIATRIC AGE GROUP NOT CONSIDERED ELSEWHERE Duplication of the Colon
(Bassj

This is a rare congenital abnormality classified into two types: (1) lesions limited to the colon and (2) duplications of the colon associated with duplications of the genitourinary tract. The colon may. be duplicated in whole or in part, and when segmentally duplicated it is usually the splenic flexure and descending colon that are affected. It may, however, be duplicated from an area just above the cecum to the rectum. When associated with duplications of the genitourinary tract, one may separate this latter group into two types: (a) those with duplication of the urinary bladder and vagina and (b) those with duplication of the urinary bladder alone. The duplicated portion of the colon may empty into oe of the portions of the duplicated urinary bladder.