Fig. 17
From: A closer look at the stoma: multimodal imaging of patients with ileostomies and colostomies
Two cases of diversion proctitis. a-c) a year after colectomy and terminal ileostomy for Crohn’s disease, initial CT (a) performed for perineal pain showed fluid-filled inflamed rectal stump with uniformly thick walls (thin arrows), mesorectal engorgement (*) and presacral fluid (arrowhead). Despite transanal drainage of fluid, repeated CT three months later (b-c) showed increased thickness and appearance of stratification at inflamed rectal walls (thin arrows). d-f) following colonic resection for indeterminate colitis, MRI including sagittal T2- (a), fat-suppressed axial T2- and post-gadolinium fat-suppressed T1-weighted (C) sequences showed markedly thickened oedematous and hypervascular rectal walls (thin arrows), perirectal fluid (*) and downwards invagination of the closed apex of rectal stump (arrowheads)