Inflammatory bowel thickening and enhancement peritoneal diseases. Medical search. Frequent questions

In small-bowel obstruction imaging, certain radiologic investigations can be used to confirm the diagnosis and severity of the obstruction, but not its etiology. (medscape.com)
this caused the small-bowel obstruction. (medscape.com)
The clinical diagnosis was small-bowel obstruction resulting from adhesions. (medscape.com)
This plain abdominal radiograph of a 55-year-old woman presenting with features of intestinal obstruction shows dilated loops of the small bowel associated with thickened edematous valvulae conniventes and a strangulated left inguinal hernia (arrow). (medscape.com)
A CT scan of a 36-year-old woman with Gardner syndrome presented with features of small-bowel obstruction. (medscape.com)
Do not use oral contrast in patients with suspected small-bowel obstruction. (medscape.com)
A transition zone is required for the diagnosis of small-bowel obstruction. (medscape.com)
CT of the abdomen and pelvis with IV contrast is usually appropriate for the initial imaging of a suspected small-bowel obstruction with an acute presentation. (medscape.com)
Albeit rare, ECFs severely impair patients' quality of life, and cause significant morbidity from bowel obstruction, sepsis, diarrhoea, malabsorption and weight loss [1-3]. (eurorad.org)
Atri et al studied 99 adult patients who underwent 105 nonenhanced CTs and enhanced CTs and found that the 2 procedures had comparable accuracy in diagnosing mechanical small-bowel obstruction and that they can be interpreted by reviewers of varying expertise. (medscape.com)
O'Daly et al conducted a retrospective review of 88 patients who had acute adhesional small-bowel obstruction and underwent CT, and 58 (66%) were managed conservatively and 30 (34%) underwent surgery. (medscape.com)
Scans for hyperemergent conditions such as ruptured aneurysm, aortic dissection, or high-grade bowel obstruction with suspected ischemia should not be delayed for administration of oral contrast. (radiologykey.com)
Compromised blood flow to the bowel causing ischemic necrosis is referred to as strangulated obstruction. (dermatologyadvisor.com)
The proximal small bowel is normally relatively sterile, but with a high grade or complete obstruction, bacterial overgrowth with anaerobes such as Bacteroides may result in feculent vomiting. (dermatologyadvisor.com)
but currently in the Western world, adhesions have become the most frequent cause of adult small bowel obstruction, accounting for 74% of cases in a series by Miller. (dermatologyadvisor.com)
The most frequent etiology of bowel obstruction varies by age. (dermatologyadvisor.com)
A closed-loop obstruction occurs when inflow to the loop of bowel and outflow from the loop are both blocked. (basicmedicalkey.com)
It has been reported in many non-fatal conditions, such as inflammatory bowel disease, intra-abdominal abscess, bowel obstruction, paralytic ileus, endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy, and gastric dilatation. (e-jyms.org)
60.0% due to complications of peritoneal disease, most commonly intestinal obstruction (I/O). 14.3% required emergency surgery for I/O and 23.8% required abdominal cope loop and ureteric stent insertion. (medicinelakex1.com)
So every patient who shows up with a bowel obstruction should have surgery, to prevent ischemic complications, right? (crashingpatient.com)
First off, the traditional terminology used to classify bowel obstruction probably should be discussed. (crashingpatient.com)
Partial bowel obstruction describes a patient who has dilated bowel on imaging, has nausea and vomiting, but continues to pass flatus or even stool intermittently. (crashingpatient.com)
Let me say a quick word about the pathophysiology of bowel ischemia in the setting of bowel obstruction. (crashingpatient.com)
On a very basic level, and obstruction that results in, or is caused by, twisting of the mesenteric vasculature (volvulus, internal hernia, or adhesion-related mesenteric restriction) can, and often does, result in ischemic bowel. (crashingpatient.com)
As an obstruction progresses, the bowel proximal to the point of obstruction becomes progressively more dilated over time as the succus and GI secretions accumulate. (crashingpatient.com)
This latter type of bowel ischemia is the reason behind the traditional dictum in surgical training to "Never let the sun rise or set on a complete bowel obstruction. (crashingpatient.com)
Dr. Martin Zielinski led a group of providers to create and prospectively validate a model to predict ischemic bowel obstruction. (crashingpatient.com)
The team showed that three signs are associated with an ischemic obstruction: obstipation (no flatus or stool for 24 hours), mesenteric edema on CT scan, and absence of small bowel feces sign on CT. (crashingpatient.com)

[ 1 ] Conventional plain radiography (see the images below) is the investigation of choice for patients with suspected small-bowel obstructions. (medscape.com)
Examples of closed-loop obstructions are torsion of a loop of small intestine around an adhesive band ( Fig. 49-2 ), incarceration of the bowel in a hernia, volvulus of the cecum or colon, or development of an obstructing carcinoma of the colon with a competent ileocecal valve. (basicmedicalkey.com)
But how reliably can a surgeon categorize bowel obstructions as complete or partial? (crashingpatient.com)
In one study, more than 50% of bowel obstructions with ischemia were misdiagnosed. (crashingpatient.com)

Evaluation of the mesentery is often neglected during routine ultrasound (US) because of inadequate training and unfamiliarity with the common US features encountered with mesenteric disease. (sajr.org.za)
CT plays an essential role in the diagnosis of mesenteric disease. (sajr.org.za)
Secondary involvement of the mesentery from tumours elsewhere is much more common than primary mesenteric neoplasms such as desmoid tumour, inflammatory myofibroblastic tumour (IMFT), and others. (sajr.org.za)
Some mesenteric diseases present with distinctive imaging findings while others have similar findings, thereby complicating their differential diagnosis. (sajr.org.za)
Most cases of HPVG are historically related to mesenteric ischemia accompanied by bowel necrosis. (e-jyms.org)

Signs of bowel ischemia such as pneumatosis, portal venous gas, or pneumoperitoneum should prompt urgent surgical evaluation. (medscape.com)

Reported imaging patterns include ileal mass, long stenosis with heterogeneous submucosa, short severe stenosis with upstream bowel dilatation, irregular asymmetric circumferential thickening. (eurorad.org)
We herein report a case of EGE limited to the second part of the duodenum that caused circumferential stenosis due to massive wall thickening. (bvsalud.org)
BACKGROUND: Analysis of the perception of the disease in borderline stenosis of the orifice of the internal carotid artery (ICA) (up to 69% in diameter) in asymptomatic patients. (bvsalud.org)
It is necessary to perform the psychological work with patients with carotid stenosis in order to form in them more adaptive types of perception of the disease, understanding of the disease and a positive attitude towards treatment. (bvsalud.org)

Consider the risk of contrast-induced nephropathy in patients with chronic kidney disease. (medscape.com)
During the subject program, cardiac diseases on HF failure produce that the peptide of fruity few glyhexamide of HF may Finally bypass Suppressing operatively prior often used by oxidation guidelines and that maximum patients may maintain ingesting especially among younger methods. (augenta.net)
The best way to manage these patients is to be aware of the possibility of bowel injury, re-examine them frequently, and re-image them or even send them for ex-lap if their condition changes . (emdocs.net)
Therefore, US is widely used and frequently chosen as the first imaging modality for most abdominal imaging, both for general abdominal examinations and for patients suspected of having splenic diseases. (e-ultrasonography.org)
Patients with a long history of recurrent abdominal pain and who on imaging were found to have a diffusely thickened gall bladder wall, with cholelithiasis, choledocholithiasis and submucosal hypoattenuated nodules were likely to have XGC while those with anorexia,weight loss,focal thickening of the gallbladder wall on imaging and dense local organ infiltration were more likely to have GBC. (medicinelakex1.com)
Cytoreductive surgery (CRS) and hyperthermic intra-peritoneal chemotherapy (HIPEC) provide prolonged survival in selected patients with colorectal (CLR) peritoneal carcinomatosis. (medicinelakex1.com)
We performed a retrospective review of a prospectively maintained database of 34 patients who underwent CRS and HIPEC and 21 patients who underwent PC for CLR peritoneal carcinomatosis, at the National Cancer Centre Singapore (NCCS), from Jan 2008 to Dec 2013. (medicinelakex1.com)
CRS and HIPEC confer prolonged survival compared to PC in patients with CLR peritoneal carcinomatosis. (medicinelakex1.com)
Patients treated with palliative chemotherapy suffer significant morbidity from disease progression that disrupts chemotherapy and results in significantly longer hospitalization. (medicinelakex1.com)

Generally (75% of cases) located in the mid-to-distal ileum, SBAC may be indistinguishable from acute inflammatory CD or benign fibrotic stricture. (eurorad.org)
Endometriosis is a common benign and chronic inflammatory gynaecological disease due to functional endometrial glands and stroma in an ectopic location outside the uterine cavity [ 1 ]. (polradiol.com)
Prediction of benign and malignant endometrial disease: hysterosonographic-pathologic correlation. (radiopaedia.org)

Multiplanar CT-enterography (Fig. 1) with oral polyethylenglycole solution confirmed two ventral enterocutaneous fistulas with characteristic tram-track appearance, mixed fluid and air content, and showed a markedly thickened ileal segment with non-stratified enhancement which appeared to infiltrate the anterior abdominal wall. (eurorad.org)
Peritoneal fluid detected on a CT scan was identified as an independent predictor of surgical intervention. (medscape.com)
Transudative fluid is lost into the peritoneal cavity. (dermatologyadvisor.com)
When a loop of bowel becomes obstructed, intestinal gas and fluid accumulate. (basicmedicalkey.com)
Other findings include a visible bowel wall lesion, "misty" mesentery, intestinal pneumatosis, free fluid, and extraluminal fecal matter. (emdocs.net)
While a CT may be able to directly visualize breaks in the bladder wall, findings are usually more non-specific: free fluid, ascites, or bladder wall enhancement. (emdocs.net)

This drawback is explained by immunological theory, which states that normally refluxed menstrual endometrium is cleared from the peritoneal cavity by macrophages, natural killer cells, and lymphocytes preventing endometriosis in most cases. (polradiol.com)
However, there is reduced immunological clearance of refluxed endometrium from the peritoneal cavity, causing endometriosis in some women with immune system dysfunction. (polradiol.com)

Recognition of cell wall components derived from intestinal bacteria by Toll-like receptors (TLRs) induces the production of these pro-inflammatory cytokines by macrophages and dendritic cells in human IBD and experimental colitis model. (bvsalud.org)

If necrosis progresses to all layers of the bowel, perforation is inevitable. (dermatologyadvisor.com)
Bowel necrosis may also result from direct compression of the blood supply, as can be seen with volvulus or with a tight hernia ring. (dermatologyadvisor.com)

However, free air may be as little as 50% sensitive for detecting bowel perforation. (emdocs.net)

Incidence of primary large bowel lymphomas comprises only 0.2-0.6% of large bowel malignant tumors ( 3 ). (frontiersin.org)
Diffuse large B-cell lymphoma is the most common histologic subtype of NHL, with ENKTL of the large bowel being less frequent ( 4 ). (frontiersin.org)

The current spread of computed tomography scan promotes not only the early detection of related severe diseases but also the identification of other causes of HPVG. (e-jyms.org)

Albeit difficult, preoperative diagnosis of malignant ECFs impacts treatment since it requires en-bloc resection plus chemotherapy. (eurorad.org)

The polycystic kidney diseases are a group of genetically heterogeneous disorders and a leading cause of kidney failure. (basicmedicalkey.com)

Acute appendicitis remains one of the most common surgical diseases encountered by physicians. (medscape.com)
Endometritis can be acute or chronic and may arise in an obstetric setting, such as following delivery or miscarriage , or in a non-obstetric setting due to pelvic inflammatory disease (PID) or endometrial instrumentation. (radiopaedia.org)

Features of non-mass enhancement include its distribution, its internal enhancement pattern, and whether the enhancement is symmetric or asymmetric. (radiologyassistant.nl)

This radiograph shows markedly distended loops of small bowel, with effacement of the valvulae in the mid abdomen. (medscape.com)

Metastatic theory or Halban's theory also explains the presence of endometriosis at distant and unusual sites like skin, umbilicus, bowel wall, pleura lungs, ureter, endocardium, pelvic lymph nodes, and retroperitoneum and extremely rare sites such as brain. (polradiol.com)
Endometriosis is a chronic inflammatory disease that affects approximately 10% of fertile women [1], up to 50% of women with infertility problems and up to 70% of women with chronic pelvic pain [2]. (fortuneonline.org)

Nowadays suspected CD complications warrant investigation with CT or MR-enterography: multiplanar cross-sectional imaging readily visualizes the fistulous path and identifies the bowel segment of origin [1, 5, 6]. (eurorad.org)
Magnetic resonance imaging (MRI) is an excellent non-invasive modality that helps in non-invasive diagnosis, with excellent delineation of the disease extent, and thus provides a presurgical mapping of the disease, which is helpful for the operating surgeon [ 6 ]. (polradiol.com)
However, to the authors' knowledge, there are not enough up-to-date ultrasonographic imaging reviews of splenic diseases [ 2 - 5 ]. (e-ultrasonography.org)
Endometritis is a clinical diagnosis and caution should be taken due to the overlap of expected postpartum imaging findings and the ones related to the inflammatory process. (radiopaedia.org)
3. Nalaboff KM, Pellerito JS, Ben-levi E. Imaging the endometrium: disease and normal variants. (radiopaedia.org)
6. Gupta A, Desai A, Bhatt S. Imaging of the Endometrium: Physiologic Changes and Diseases: Women's Imaging. (radiopaedia.org)

Just as in mammography and ultrasound, we look at its shape, its margins and its internal characteristics: this includes its T1- and T2-characteristics as well its enhancement pattern. (radiologyassistant.nl)

If the chest is to be studied, images are obtained in the arterial phase of contrast enhancement, followed by a pause sufficiently long to image the abdomen and pelvis in the late arterial or early portal venous phase. (radiologykey.com)
On CT, it appears as a well-defined or ill-defined mass showing heterogenous enhancement usually in the portal venous phase and it may infiltrate the adjacent organs. (sajr.org.za)
Hepatic portal venous gas (HPVG) is a rare radiographic finding associated with severe intra-abdominal disease and fatal outcome. (e-jyms.org)

In later stages, increased venous pressure in the bowel wall can result in hemorrhage into the lumen, worsening hypovolemia and further increasing intraluminal pressure. (dermatologyadvisor.com)

We hypothesize that PC is suboptimal due to complications arising from peritoneal disease that disrupts chemotherapy. (medicinelakex1.com)
Secondary outcomes of frequency of chemotherapy disruptions, need for invasive interventions, and duration of hospitalization for complications of peritoneal disease were evaluated. (medicinelakex1.com)

As dilation worsens, bowel wall edema develops, leading to deranged absorptive mechanisms, further exacerbating the increased luminal pressure. (dermatologyadvisor.com)
Healthy bowel can tolerate an impressive amount of dilation provided that such dilation occurs gradually . (crashingpatient.com)
If the bowel is not healthy (history of IBD, prior surgery, radiation, etc.), or if the dilation happens quickly, the luminal pressures exceed the perfusion pressure of the intestinal capillary network, and blood flow stops. (crashingpatient.com)

To date, three clinical distinct phenotypes of endometriosis of the pelvis are recognized: ovarian cysts (endometrioma), peritoneal implants of endometriotic lesions and deep infiltrating endometriosis [1]. (fortuneonline.org)
Enhancing lesions are divided into three main categories: focus/foci, masses, and areas of non-mass enhancement (1). (radiologyassistant.nl)
These lesions are typically stable on follow-up and are considered to be a part of the normal background enhancement pattern in the breast. (radiologyassistant.nl)

OS was calculated from the date of diagnosis of peritoneal metastases till death. (medicinelakex1.com)

When signs of peritoneal irritation or frank peritonitis develop, there is a high level of suspicion that the viability of the bowel is compromised. (basicmedicalkey.com)
Extravasation of urine into the peritoneal space can result in chemical peritonitis and sepsis . (emdocs.net)

The spleen, sometimes called "the forgotten organ" of the abdomen, has received less attention than other abdominal solid organs, as splenic diseases are less common and frequently clinically asymptomatic [ 1 ]. (e-ultrasonography.org)

Histologic analysis reveals a thickened sub apical collagen layer and increased lymphocytes in the lamina propria. (passmed.uk)

Pathology reported a 20x18x9 cm bowel mass including skin surface with fistulous orifices, with a 7-cm long ileal adenocarcinoma with transmural growth, infiltrating the perivisceral fat, anterior abdominal wall and subcutaneous planes. (eurorad.org)
Small bowel adenocarcinoma (SBAC) is a rare but dreaded occurrence in CD, which generally affects males with long-standing CD, 33 times more commonly than in the general population, but is disguised by nonspecific and varied manifestations mimicking active or obstructive disease. (eurorad.org)
SBO can also be caused by small intestinal tumors such as carcinoid, lymphoma, and small bowel adenocarcinoma. (dermatologyadvisor.com)

Laparotomic en-bloc resection of ileal mass, anterior abdominal wall and subcutaneous tissue involved by enterocutaneous fistulas and a segment of transverse colon was performed (post-surgical status shown in Fig. 2a, b). (eurorad.org)

They demonstrate various contrast enhancement patterns including early peripheral enhancement because of vascular tissue ( Figure 1 ), delayed central enhancement of the fibrotic components, heterogenous, homogenous and absent enhancement. (sajr.org.za)

Although primary neoplasms arising in the mesentery are rare, the mesentery is a major avenue for the dissemination of tumours, which can spread through hematogenous, lymphatic, direct or peritoneal seeding. (sajr.org.za)

Another short poorly distensible ileal tract with mural thickening of lesser degree was consistent with known Crohn's disease. (eurorad.org)
Extranodal NK/T cell lymphoma is a rare non-Hodgkin lymphoma mainly involving the upper aerodigestive tract, even rarer is primary extranasal disease involving the intestine. (frontiersin.org)

It is characterised by normal endoscopic appearances, microscopic features of colonic inflammation and thickening of the sub epithelial collagen layer. (passmed.uk)

FIGURE 339-1 Scheme of the primary cilium and cystic kidney disease proteins. (basicmedicalkey.com)

The axial contrast-enhanced CT scan through the midabdomen shows an extrinsic mass compressing a loop of small bowel. (medscape.com)

The loops of the small bowel are dilated, and associated with small calcific nodules in the right iliac fossa are seen. (medscape.com)
The abdominal radiograph shows dilated loops of small bowel, but the concentration of several loops of small bowel in the right hypochondrium should be noted as this finding is suggestive of malrotation. (medscape.com)
Trauma is the most common cause of small bowel perforations. (emdocs.net)
Focus (or when multiple, foci) is an area of enhancement measuring less than 5 mm in diameter which is too small to characterize. (radiologyassistant.nl)

Abdominal CT revealed multi-segmental intestinal wall thickening. (frontiersin.org)

Anorexia, nausea, and vomiting are typically associated with the disease. (medscape.com)

PC2 and FPC both interact with kinesin 2 (KIF 3A/B). Localization of disease proteins in the cilium, the transition zone, and the basal body is color coded. (basicmedicalkey.com)

Most ECFs develop either through an abdominal scar weeks or months after gastrointestinal surgery, or as a complication of fistulizing Crohn's disease (CD). (eurorad.org)

Oral contrast is not routinely administered in the trauma setting, although oral and/or rectal contrast can be given to evaluate suspected penetrating injuries to the bowel. (radiologykey.com)

Man with long-standing history (over 30 years) of Crohn's disease including previous ileocaecal resection and anal fistulectomy. (eurorad.org)

Anatomy16

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Obstructions4

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