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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…

Small Bowel Obstruction

KEY FACTS Terminology Obstruction or blockage of ≥ 1 small bowel (SB) segments by intrinsic or extrinsic narrowing of SB lumen Imaging SB > 3 cm diameter on radiographs, 2.5 cm on CT Air-fluid levels on upright or decubitus radiograph Transition zone between dilated and collapsed bowel is critical to define presence, site, and cause of obstruction All better determined on CT than on plain films…

Ileus

KEY FACTS Terminology Proportional gaseous dilatation of large and small bowel (SB) due to lack of intestinal peristalsis, not mechanical obstruction Imaging CT or abdominal plain films (supine, upright, decubitus) Proportional dilatation of SB and colon with no transition point SB > 3 cm on plain films, 2.5 cm on CT Air-fluid levels on upright and decubitus films Top Differential Diagnoses SB or colonic obstruction Intestinal…

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…