Gastrointestinal Imaging

Colitis cystica profunda

uncommon condition seen mostly in young adults but occurring at any age. It is characterized by the presence of multiple benign cystic structures situated in the wall of the colon beneath the muscularis mucosa and even penetrating the muscularis propria. The cysts are up to 4 cm in diameter and are filled with thick mucinous material. They are lined by a cuboidal flattened epithelium. Colitis cystica profunda is mostly localized in the rectum and is commonly associated with solitary ulcer syndrome and with rectal prolapse. The cause is unknown but it is assumed that the cysts are either of inflammatory or of traumatic aetiology. Clinical symptomatology includes rectal blood and mucus loss and intense lower abdominal pain.

Barium studies will display narrowing and irregularity of the lumen of the rectum due to the multiple intramural encroaching cystic structures. Due to their fluid content these cysts have a lower density than soft tissue and the radiographic appearance can be mistaken for pneumatosis coli. The latter condition, however, rarely occurs in the rectum.

ALB