The findings on the plain abdominal radiographs of 15 patients with cy
tomegalovirus (CMV) colitis and AIDS were reviewed and compared to an
age, sex, CD4 count and symptom-matched control group. The radiographs
were examined for mucosal thickening, bowel dilatation, pneumatosis a
nd perforation. Nodular mucosal lesions were the most significant abno
rmality in those with CMV colitis being present in seven compared to n
one in the control group (P = 0.006 two tailed). Differences between t
he CMV colitis group and the control group as regards the other featur
es were not significant. The finding of pneumatosis is the first time
this has been described in patients with CMV colitis and AIDS. No evid
ence of perforation was demonstrated and this is attributed to a high
index of suspicion in those with characteristic signs and symptoms in
addition to early sigmoidoscopy and prompt treatment.