(Left) Graphic shows a schematic representation of various processes that may narrow the lumen of the colon. Analyzing the borders and placing the lesion in the correct anatomic compartment (mucosal, submucosal, or extrinsic) are the initial steps in developing an appropriate differential diagnosis.
(Right) Spot film from a double-contrast barium enema shows a classic “apple core” lesion . Abrupt, short segment narrowing is typical of malignant lesions.
Semilunar folds Ileocecal valve Appendix Taeniae coli Epiploic appendage Rectal valves Levator ani muscle (Top) Graphic shows the surface and mucosal views of the colon. Three flat bands of smooth muscle, the taeniae coli, run the length of the colon. The semilunar folds lie at right angles to the taenia creating the haustra.
Middle colic artery Right colic artery Ileocolic artery Arc of Riolan Marginal artery (of Drummond) Superior mesenteric artery Left colic artery Inferior mesenteric artery Sigmoid arteries (Bottom) The superior mesenteric artery supplies the colon from the appendix through the splenic flexure, with the inferior mesenteric artery supplying the descending colon through the rectum. These arterial branches are highly variable. All are connected by anastomotic arterial arcades and by the marginal artery (of Drummond) and arc of Riolan, which also anastomose with branches of the inferior mesenteric artery that feed the descending and sigmoid colon.
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Diagnostic Imaging_ Gastrointes - Michael P Federle