Ischemia of the colon

The characteristic radiographic features of ischemia of the colon are thumbprinting, thickening of the folds, pseudosacculations, tubular narrowing, and stricture. The differential diagnosis includes carcinoma and granulomatous inflammatory disease. The stricture of infarction is smooth and tapering, with a concentric lumen and without overhanging margins or contour defects. Skip lesions are unusual, but sacculations are common. In contrast to these findings, the frequent features of granulomatous disease are cobblestoning, skip lesions, and small punched-out ulcers. Carcinoma demonstrates overhanging margins, eccentric lumen, and, in the early stages, a contour defect.