Comment by saeed rad on November 3, 2009 at 2:17am
Dear Dr Mughal,
Thanks for the comment and only thing to notice is the deformity of the transvrse colon due to peritoneal deposits like pseudomyxoma peritoneai. You were right in your explanation except for the midtransverse colon air filling in supine position! Air is always light and could ascend midtrasverse colon in supine position, reminding you of cut-off sign in pancreatitis. Compression of the vertebral column over transverse colon appears to be seen in prone position not in supine. Anyhow thanx for the comment.
plain abdominal radiograph in supine position shows distorted haustral pattern in mid transverse colon with luminal narrowing and proximal dilated segment. paucity of small bowel gas shadow is also appreciated. these findings should be confirmed on prone or erect radiographs because in supine position mid transverse colon appears narrowed due to impression of vertebral bodies and if findings are same on prone or erect radiographs then presence of neoplastic process should be suspected and further evaluation with double contrast barium enema or preferably ct scan is required.
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