Loss of haustration

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Loss of haustration refers to disappearance of the normal colonic haustral folds, resulting in a smooth-walled, featureless colon. Radiologically, this is a classic sign of chronic colonic disease leading to muscular and mucosal damage with fibrosis.

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Etiopathogenesis

Haustra are sacculations produced by the circular and longitudinal muscle layers of the colon.
Loss of haustra occurs due to chronic inflammation, fibrosis, or muscular atony that destroys or remodels these folds.

Radiology

Lead pipe colon = pathognomonic of long-standing UC.
Crohn’s disease rarely shows complete haustral loss; skip areas, asymmetric involvement, and “string sign” help differentiate.
Always correlate with history (inflammatory bowel disease, radiation, infection, ischemia).

![Loss of haustration: When the colon is involved in Crohn's disease a decrease of haustral folds can be seen. A complete loss of haustration results in a smooth surface. This is also a common finding in ulcerative colitis and known as 'lead pipe' colon. The coronal post-contrast T1 image shows loss of haustral folds throughout the colon in a patient with chronic Crohn's disease.

Carl Puylaert, Jeroen Tielbeek and Jaap Stoker, Academic Medical Centre, Amsterdam, the Netherlands The Radiology Assistant : Crohn’s disease - role of MRI. Published February 17, 2016. https://radiologyassistant.nl/abdomen/bowel/crohn-s-disease](attachment:551e5d16-a8ba-4e8f-9fe3-3fa5fe3a7813:a5681a1d922d7d_13.jpg)

Loss of haustration: When the colon is involved in Crohn's disease a decrease of haustral folds can be seen. A complete loss of haustration results in a smooth surface. This is also a common finding in ulcerative colitis and known as 'lead pipe' colon. The coronal post-contrast T1 image shows loss of haustral folds throughout the colon in a patient with chronic Crohn's disease.