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Bowel Ischemia

KEY FACTS Terminology Small bowel (SB) ischemia resulting from mesenteric arterial or venous narrowing or occlusion, leading to inadequate supply of nutrients and oxygen Imaging Best imaging tool CT angiography; multiplanar reformations; water for oral contrast Catheter angiography for confirmation & treatment Imaging findings vary, based on etiology and acuity of ischemic injury Acute arterial thrombosis or embolus Little SB wall thickening, mesenteric edema, or ascites…

Pneumatosis of the Intestine

KEY FACTS Terminology Pneumatosis is descriptive sign, not disease or diagnosis Cystic or linear collections of gas in subserosal or submucosal layers of GI tract wall Pneumatosis intestinalis: Most common form of intramural gas, found in small bowel more often than colon Pneumatosis coli: Rounded collections of gas in distal colonic wall, usually asymptomatic finding You’re Reading a Preview Become a Clinical Tree membership for Full…

Crohn’s Disease

KEY FACTS Terminology Disease of unknown etiology characterized by transmural inflammation of GI tract Imaging CT and MR enterography have supplanted most barium studies for diagnosis in adults and children Faster to perform, less operator dependent, more sensitive and specific Allow assessment of extraintestinal disease (e.g., cholangitis; arthritis) Multiplanar CT or MR enterography Distend bowel with water ± neutral contrast agent (e.g., VoLumen) Bolus IV contrast medium…

Whipple Disease

KEY FACTS Terminology Rare systemic disease caused by Tropheryma whipplei infection leading to multiple systemic manifestations, including chronic diarrhea and malabsorption You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Intestinal Lymphangiectasia

KEY FACTS Terminology Primary intestinal lymphangiectasia (Waldmann disease) Rare congenital disorder characterized by hypoproteinemia, peripheral edema, and lymphocytopenia resulting from loss of lymphatic fluid into intestine Important cause of protein-losing enteropathy Secondary: Much more common Causes include mesenteric or retroperitoneal node dissection (obliterates lymphatics) Right heart failure; fibrosing mesenteritis; retroperitoneal fibrosis are also implicated Imaging Contrast-enhanced, multiplanar CT is 1st-line imaging test Diffuse small bowel (SB)…

Intestinal Parasites and Infestation

KEY FACTS Terminology Enteric infection with roundworm Ascaris lumbricoides (ascariasis) Enteric protozoal infection with Giardia lamblia (giardiasis) Cryptosporidium (cryptosporidiosis) Entamoeba histolytica (amebiasis) You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Small Intestine: Imaging Approach and Differential Diagnosis

Embryology and Congenital Malformations The small intestine and the right side of the colon constitute the embryologic midgut, which herniates into the umbilical cord during the process of marked elongation in fetal development. Following a 270° counterclockwise rotation, the midgut returns to the peritoneal cavity. Errors during this complex series of events are common, resulting in varying degrees of malrotation ± volvulus. This may result in…