Atlas of Gastrointestinal Imaging Figure 2.1.4 Colonic perforation from toxic ulcerative colitis

FIGURE 2.1.4 Colonic perforation from toxic ulcerative colitis. Supine radiograph (A) from a patient with severe abdominal pain and leukocytosis shows colonic fold thickening ("thumbprinting") and massive pneumoperitoneum (Rigler's sign) related to perforation from toxic colitis. This was the initial presentation of UC in this patient. Contrast-enhanced CT image (B) from another patient with colonic perforation from UC shows massive intraperitoneal air (asterisks) anterior to an inflamed transverse colon. Note the prominent inflammatory pseudopolyp (arrowhead).
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