On CT, there is gas in the bowel wall (white arrows). White arrow on conventional radiograph points to air in colon which abruptly terminates at the splenic flexure. For children with recurrent abdominal pain, bloating and constipation, a barium enema X-ray is recommended. Inflammatory Bowel Disease such as Crohn’s DiseaseĬolon Cutoff Sign. Other diseases besides pancreatitis can produce a similar picture of air abruptly ending at the splenic flexureĭifferential Diagnosis for Colon Cutoff Sign.The transverse colon being the highest part of the large bowel when the patient is supine, contains air and is frequently dilated in the Colon Cutoff Sign.
This produces spasm of the transverse colon or actual physical narrowing of the splenic flexure.The spleen rests on the shelf formed by this ligament.The phrenicocolic ligament is a peritoneal fold extending from the splenic flexure to the posterolateral aspect of the left hemidiaphragm.In pancreatitis, the disease in which it was described, it is caused by inflammatory exudate from the pancreas which infiltrates the transverse mesocolon via the phrenicocolic ligament.Originally described on conventional radiography, it has the same appearance and implications on CT Colonoscopy, Flexible, Proximal to Splenic Flexure with Removal of Foreign Body.Even though the bowel remained viable, a 45cm segment was resected and a primary anastomosis between the transverse and descending colon was performed. All three splenic flexure ligaments were congenitally absent. The pattern of bowel gas in which there is air in a slightly dilated transverse colon up to, but not beyond, the splenic flexure The radiological findings were confirmed with the splenic flexure of the colon having rotated 360 along its mesentery ( fig 3 ).