HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Macari, M. Articles by Megibow, A. J. Search for Related Content PubMed PubMed Citation Articles by Macari, M. Articles by Megibow, A. J.

The Accordion Sign at CT: a Nonspecific Finding in Patients with Colonic Edema¹

¹ From the Department of Radiology, NYU Medical Center, Tisch Hospital, 560 First Ave, Suite HW 202, New York, NY 10016. Received July 28, 1998; revision requested August 18; revision received September 2; accepted November 25. Address reprint requests to M.M.

PURPOSE: To determine whether the "accordion sign" is a specific computed tomographic (CT) sign of Clostridium difficile colitis.

MATERIALS AND METHODS: Fifty-seven patients with CT evidence of severe colitis, as judged by colonic wall thickening, an abnormal haustral pattern, the target sign, and stranding of the pericolic fat, were identified from a computerized CT database for 25 months. CT images were retrospectively evaluated for the presence of oral contrast material in the colon and for the accordion sign. The medical and laboratory records of all patients were reviewed and correlated with CT findings to establish the cause of colitis.

RESULTS: Oral contrast material had reached the colon in 35 of 57 patients at the time of the CT examination. The images in 15 of these patients demonstrated the accordion sign, and those in 20 patients did not. C difficile colitis was documented in four of the 15 cases displaying the accordion sign. In the remaining 11 patients, a different cause was documented. Oral contrast material had not reached the colon in the remaining 22 patients. Within this group with findings similar to the accordion sign, five patients had documented C difficile colitis, and four had colitis from other causes.

CONCLUSION: The accordion sign is indicative of severe colonic edema or inflammation, but it is not specific for C difficile colitis.

Index terms: Colitis, 75.2043, 75.261, 75.266, 75.269 • Computed tomography (CT), colon, 75.12112

This article has been cited by other articles:

				M. d'Almeida, J. Jose, J. Oneto, and R. Restrepo Bowel Wall Thickening in Children: CT Findings RadioGraphics, May 1, 2008; 28(3): 727 - 746. [Abstract] [Full Text] [PDF]

				E. L. Ormsby, C. Duffield, F. Ostovar-Sirjani, J. P. McGahan, and C. Troppmann Colonoscopy Findings in End-Stage Liver Disease Patients with Incidental CT Colonic Wall Thickening Am. J. Roentgenol., November 1, 2007; 189(5): 1112 - 1117. [Abstract] [Full Text] [PDF]

				R. F. Thoeni and J. P. Cello CT Imaging of Colitis Radiology, September 1, 2006; 240(3): 623 - 638. [Abstract] [Full Text] [PDF]

				L. Xiong, K. N. Chintapalli, G. D. Dodd III, S. Chopra, J. A. Pastrano, C. Hill, J. R. Leyendecker, R. M. Abbott, D. Grayson, and J. Feig Frequency and CT Patterns of Bowel Wall Thickening Proximal to Cancer of the Colon Am. J. Roentgenol., April 1, 2004; 182(4): 905 - 909. [Abstract] [Full Text] [PDF]

				M. Macari and E. J. Balthazar CT of Bowel Wall Thickening: Significance and Pitfalls of Interpretation Am. J. Roentgenol., May 1, 2001; 176(5): 1105 - 1116. [Full Text] [PDF]