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Computed tomography enterography

Ashraf F Hefny, Adel Z Ayad, Nikolay Matev, Masoud O Bashir
INTRODUCTION: Psyllium in granular dosage form is used as an over - the counter safe laxative drug. It has a considerable hygroscopic propriety which allows it to retain water and expands rapidly to become many times of its original size. PRESENTATION OF THE CASE: 21-year-old man presented to the Emergency Department complaining of lower abdominal pain and constipation for five days. He was discharged home on Psyllium for treatment of the constipation. Two days later, he returned to the Emergency Department complaining of increased abdominal distension without passing any stools...
October 8, 2018: International Journal of Surgery Case Reports
Isabelle De Kock, Louke Delrue, Clarisse Lecluyse, Pieter Hindryckx, Martine De Vos, Geert Villeirs
Background Assessment of Crohn's disease (CD) activity is important to identify patients with active inflammation for therapy management. Quantitative analysis can provide objective measurement of disease presence. Purpose To evaluate the feasibility of quantitative analysis of contrast-enhanced dual-energy computed tomography (DECT) data in detection of small bowel inflammation in patients with CD with an emphasis on iodine quantification. Material and Methods DECT enterography was prospectively performed in 20 patients with active CD and in 20 healthy individuals, as the control group...
September 5, 2018: Acta Radiologica
Jingyun Cheng, Hui Xie, Hao Yang, Ke Wang, Guobin Xu, Guangyao Wu
Objective: To explore the feasibility of computed tomography enterography (CTE) in the quantitative evaluation of the activity of Crohn's disease (CD). Methods: There were 49 CD patients with whole clinical, enteroscopy, and CTE data to be analyzed retrospectively. The patients were graded as inactive (0-2), mild (3-6), and moderate-severe group (>6) based on simplified endoscopic activity score for Crohn's disease (SES-CD). The differences in bowel wall thickening, mural hyperenhancement in the portal vein period, and the ΔCT values were analyzed among groups using ANOVA (analysis of variance) and q test...
2018: Gastroenterology Research and Practice
Trevor C Morrison, Michael Wells, Jeff L Fidler, Jorge A Soto
Lower gastrointestinal bleeding is defined as occurring distal to the ligament of Treitz and presents as hematochezia, melena, or with anemia and positive fecal occult blood test. Imaging plays a pivotal role in the localization and treatment of lower gastrointestinal bleeds. Imaging tests in the workup of acute lower gastrointestinal bleeding include computed tomography (CT) angiography, nuclear medicine scintigraphy, and conventional catheter angiography. Catheter angiography can also be used to deliver treatment...
September 2018: Radiologic Clinics of North America
Mark E Baker, Joel G Fletcher, Mahmoud Al-Hawary, David Bruining
Computed tomography enterography and magnetic resonance enterography are essential in the evaluation and treatment of patients with Crohn's disease. As such, examination reporting must use standardized nomenclature for effective communication. This report documents an interdisciplinary consensus of the Society of Abdominal Radiology, the Society of Pediatric Radiology, and the American Gastroenterology Association on the computed tomography enterography/magnetic resonance enterography imaging findings and imaging-based morphologic phenotypes...
September 2018: Radiologic Clinics of North America
Shannon P Sheedy, Amy B Kolbe, Joel G Fletcher, Jeff L Fidler
Computed tomography (CT) enterography is a noninvasive imaging modality with superb spatial and temporal resolution, specifically tailored to evaluate the small bowel. It has several advantages over other radiologic and optical imaging modalities, all of which serve as complementary investigations to one another. This article describes CTE technique, including dose reduction techniques, special considerations for the pediatric population, common technical and interpretive pitfalls, and reviews some of the more common small bowel entities seen with CTE...
September 2018: Radiologic Clinics of North America
Gene Kim, Jorge A Soto, Trevor Morrison
Gastrointestinal (GI) bleeding represents a broad differential of disease throughout the GI tract. The proper diagnostic evaluation of patients presenting with symptoms of GI bleeding depends on the overall clinical acuity and suspected source locations. The radiologic assessment of these patients is centered around computed tomography (CT) angiography, CT enterography, conventional angiography, and nuclear scintigraphy.
September 2018: Gastroenterology Clinics of North America
Seong Ho Park, Byong Duk Ye, Tae Young Lee, Joel G Fletcher
Computed tomography enterography (CTE) and magnetic resonance enterography (MRE) are presently state-of-the-art radiologic tests used to examine the small bowel for various indications. This article focuses on CTE and MRE for the evaluation of Crohn disease. The article describes recent efforts to achieve more standardized interpretation of CTE and MRE, summarizes recent research studies investigating the role and impact of CTE and MRE more directly for several different clinical and research issues beyond general diagnostic accuracy, and provides an update on progress in imaging techniques...
September 2018: Gastroenterology Clinics of North America
Narumi Taguchi, Seitaro Oda, Tateaki Kobayashi, Hideaki Naoe, Yutaka Sasaki, Masanori Imuta, Takeshi Nakaura, Yasuyuki Yamashita
We describe a case of small bowel Crohn's disease in which dual-energy computed tomography enterography using dual-layer spectral detector scanner contributed to quantitative assessment, and provided a higher degree of confidence pertaining to the diagnosis. Dual-layer spectral detector computed tomography enables retrospective analysis including virtual monochromatic imaging, iodine mapping, and determining the effective atomic number Z with routine scan protocols. These advanced parametric dual-energy imaging holds promising potential as an imaging biomarker for diagnosis, risk-stratification, monitoring of disease progression and therapy, and outcome prediction...
June 2018: Radiology Case Reports
Nan Zhuang, Qingli Zhu, Wenbo Li, Miaoqian Wang, Qian Yang, Wei Liu, Ji Li, Hong Yang, Weixun Zhou
RATIONALE: Primary lymphoma that arises from the intestine is an uncommon malignant tumour, while intestinal fistula caused by primary lymphoma is even rarer. Non-specific clinical performance makes early diagnosis difficult, although imaging modalities might play an essential role in the detection of intestinal fistula. PATIENT CONCERNS: Patient 1: A 60-year-old male hospitalized with diarrhoea and abdominal pain for seven months underwent computed tomography enterography (CTE) that demonstrated ileum internal fistula and ileac-sigmoid colon fistula...
July 2018: Medicine (Baltimore)
Michael L Wells, Stephanie L Hansel, David H Bruining, Joel G Fletcher, Adam T Froemming, John M Barlow, Jeff L Fidler
Acute gastrointestinal (GI) bleeding is common and necessitates rapid diagnosis and treatment. Bleeding can occur anywhere throughout the GI tract and may be caused by many types of disease. The variety of enteric diseases that cause bleeding and the tendency for bleeding to be intermittent may make it difficult to render a diagnosis. The workup of GI bleeding is frequently prolonged and expensive, with examinations commonly needing to be repeated. The use of computed tomography (CT) for evaluation of acute GI bleeding is gaining popularity because it can be used to rapidly diagnose active bleeding and nonbleeding bowel disease...
July 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Rui Feng, Kang Chao, Shu Ling Chen, Can Hui Sun, Yun Qiu, Bai Li Chen, Ren Mao, Yao He, Qing Hua Cao, Ling Xue, Zhi Rong Zeng, Sheng Hong Zhang, Min Hu Chen
OBJECTIVE: To investigate the role of heat shock protein family A member 6 (HSPA6) expression alone and in combination with clinical characteristics in distinguishing intestinal Behçet's disease (BD) from Crohn's disease (CD) with ileocolonic involvement. METHODS: Patients diagnosed with either intestinal BD or CD were enrolled. Their clinical characteristics, disease activity, laboratory test results including hypersensitive C-reactive protein (hsCRP) and erythrocyte sedimentation rate (ESR), endoscopic, pathological and radiological features were retrospectively analyzed...
June 2018: Journal of Digestive Diseases
Stephanie L Hansel, Jeffrey D McCurdy, John M Barlow, Jeff Fidler, Joel G Fletcher, Brenda Becker, Nayantara Coelho Prabhu, William A Faubion, Karen A Hanson, Sunanda V Kane, John B Kisiel, Edward V Loftus, Konstantinos A Papadakis, Darrell S Pardi, Laura E Raffals, Shayla Schoenoff, William J Tremaine, David H Bruining
Background: Ileocolonoscopy and computed tomography (CT) or magnetic resonance (MR) enterography (CTE/MRE) are utilized to evaluate patients with small bowel (SB) Crohn's disease (CD). The purpose of our study was to estimate the impact of capsule endoscopy (CE) on patient management after clinical assessment, ileocolonoscopy, and CTE/MRE. Methods: We prospectively analyzed 50 adult CD patients without strictures at clinically indicated ileocolonoscopy and CTE/MRE exams...
June 8, 2018: Inflammatory Bowel Diseases
Susana Lopes, Patrícia Andrade, Joana Afonso, Rui Cunha, Eduardo Rodrigues-Pinto, Isabel Ramos, Guilherme Macedo, Fernando Magro
Background: The treatment goal of Crohn's disease (CD) has moved towards achieving mucosal healing, resolution of transmural inflammation, and normalization of biomarkers. The purpose of this study was to evaluate how well computed tomography enterography (CTE) and fecal calprotectin (FC) correlated with endoscopic activity in newly diagnosed patients with CD and after 1 year of therapy. Methods: Consecutive patients with newly diagnosed CD were evaluated by endoscopy, CTE, and FC at diagnosis and 12 months after beginning immunosuppression...
2018: Therapeutic Advances in Gastroenterology
Jakob Köstenbauer, Philip G Truskett
Small bowel obstruction is a common and significant surgical presentation. Approximately 30% of presentations will require surgery during admission. The great challenge of adhesive small bowel obstruction (ASBO) management is the early detection of silent intestinal ischaemia in patients initially deemed suitable for conservative therapy. Recent literature emphasizes the effectiveness of computed tomography enterography and water-soluble contrast studies in the management of ASBO. Low-volume undiluted water-soluble contrast has been shown to have both triage and therapeutic value in the management of ASBO...
May 14, 2018: ANZ Journal of Surgery
Silvia Pecere, Grainne Holleran, Maria Elena Ainora, Matteo Garcovich, Franco Scaldaferri, Antonio Gasbarrini, Maria Assunta Zocco
Intestinal ultrasonography has emerged as a cheap, non-invasive and readily accessible modality for the assessment of a number of gastroenterological diseases. Over the last decade, particularly due to the widespread use of biological agents in Inflammatory Bowel Disease (IBD), guidelines regarding management and follow-up advise more regular disease assessment and surveillance in order to guide treatment adjustments, and provide more personalised care. Given the young age of the majority of patients with IBD the availability of an alternative modality to harmful radiation or the risks of endoscopy for this indication offers an appealing advantage...
August 2018: Digestive and Liver Disease
Parakkal Deepak, Joel G Fletcher, Jeff L Fidler, John M Barlow, Shannon P Sheedy, Amy B Kolbe, William S Harmsen, Terry Therneau, Stephanie L Hansel, Brenda D Becker, Edward V Loftus, David H Bruining
Background: The long-term significance of radiological transmural response (TR) as a treatment goal at the first follow-up scan in small bowel Crohn's disease (CD) has been previously shown. We examined the durability of a long-term strategy of treating to a target of radiological TR and the influence of baseline predictors on the maintenance of TR. Methods: Small bowel CD patients between January 1, 2002, and December 31, 2014, were identified with serial computed tomography enterography (CTE)/magnetic resonance enterography (MRE) before and after initiation of therapy or on maintenance therapy...
July 12, 2018: Inflammatory Bowel Diseases
Dan Carter, Lior H Katz, Eytan Bardan, Eti Salomon, Shulamit Goldstein, Shomron Ben Horin, Uri Kopylov, Rami Eliakim
Background: Small bowel involvement in Crohn's disease (CD) is frequently proximal to the ileocecal valve and inaccessible by conventional ileocolonoscopy (IC). Small bowel capsule endoscopy (SBCE) is among the prime modalities for assessment of small bowel disease in these patients. Intestinal ultrasound (IUS) is an accurate bedside fast and low-cost diagnostic modality utilized in CD for both diagnosis and monitoring. The aim of this study was to examine the accuracy of IUS in patients with suspected CD after a negative IC, and to evaluate the correlation of IUS with SBCE, inflammatory biomarkers and other cross-sectional imaging techniques...
2018: Therapeutic Advances in Gastroenterology
Cui Feng, Di Zhu, Xianlun Zou, Anqin Li, Xuemei Hu, Zhen Li, Daoyu Hu
To investigate the subjective and quantitative image quality and radiation exposure of CT enterography (CTE) examination performed at low tube voltage and low concentration of contrast agent with adaptive statistical iterative reconstruction (ASIR) algorithm, compared with conventional CTE.One hundred thirty-seven patients with suspected or proved gastrointestinal diseases underwent contrast enhanced CTE in a multidetector computed tomography (MDCT) scanner. All cases were assigned to 2 groups. Group A (n = 79) underwent CT with low tube voltage based on patient body mass index (BMI) (BMI < 23 kg/m, 80 kVp; BMI ≥ 23 kg/m, 100 kVp) and low concentration of contrast agent (270 mg I/mL), the images were reconstructed with standard filtered back projection (FBP) algorithm and 50% ASIR algorithm...
March 2018: Medicine (Baltimore)
Masaya Iwamuro, Shiho Takashima, Toshihiro Inokuchi, Masahiro Takahara, Seiji Kawano, Sakiko Hiraoka, Yoshitaka Kondo, Takehiro Tanaka, Hiroyuki Okada
A 40-year-old Japanese man with abdominal pain was referred to our hospital. The patient had been diagnosed with Crohn's disease at the age of 21 years and had since then received treatment with mesalazine and had been advocated an elemental diet. About 30 months before his visit to the hospital, he had swallowed a patency capsule, the retention of which in the ileum was subsequently detected on abdominal ultrasonography. The patient was advised to undergo the evaluation of stenosis, but he refused further investigation at that time...
2018: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
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