scholarly journals Etiology of Small Bowel Thickening on Computed Tomography

2012 ◽  
Vol 26 (12) ◽  
pp. 897-901 ◽  
Author(s):  
Lee Finkelstone ◽  
Ellen Wolf ◽  
Marjorie W Stein
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Medical Records ◽  
Final Diagnosis ◽  
Ct Scans ◽  
Common Cause ◽  
One Year

BACKGROUND: Abdominal pain is often evaluated using imaging, most often with computed tomography (CT). While CT is sensitive and specific for certain diagnoses, small bowel thickening is a nonspecific finding on CT with a broad differential diagnosis including infection, inflammation, ischemia and neoplasm.METHOD: A review of medical records of patients who underwent CT scans of the abdomen and pelvis over a one-year period and exhibited small bowel thickening were retrospectively evaluated to determine the final diagnosis.RESULTS: The etiologies of small bowel thickening on CT were as follows: infection (113 of 446 [25.34%]); reactive inflammation (69 of 446 [15.47%]); primary inflammation (62 of 446 [13.90%]); small bowel obstruction (38 of 446 [8.52%]); iatrogenic (33 of 446 [7.40%]); neoplastic (32 of 446 [7.17%]); ascites (30 of 446 [6.73%]); unknown (28 of 446 [6.28%]); ischemic (24 of 446 [5.38%]); and miscellaneous (17 of 446 [3.81%]).CONCLUSION: Infectious and inflammatory (primary or reactive) conditions were the most common cause of small bowel thickening in the present series; these data can be used to formulate a more specific differential diagnosis.

scholarly journals Idiopathic localised dilatation of the intestine in adults

2019 ◽  
Vol 12 (8) ◽  
pp. e230443
Author(s):  
Niccolò Rotigliano ◽  
Matthias Sauter ◽  
Markus von Flüe ◽  
Daniel Christian Steinemann
Keyword(s):  
Systematic Review ◽  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Small Bowel Obstruction ◽  
Small Bowel Stricture ◽  
Segmental Dilatation ◽  
Bowel Stricture ◽  
Radiological Studies

Idiopathic localised dilatation of the intestine (ILDI) presenting in adults is rare and difficult to diagnose. Only 18 cases have been reported in the literature. We report a case of a 32-year-old woman presenting with abdominal pain and intermittent small bowel obstruction. After detailed radiological studies, the patient, known for Crohn’s disease, was scheduled for laparoscopy in the suspicion of small bowel stricture. A localised dilatation of the ileum was found intraoperatively and subsequently resected. A systematic review of this rare pathology in adults is carried out. ILDI should be part of the differential diagnosis in patients with unexplained abdominal pain or gastrointestinal bleeding in the presence of segmental dilatation of the intestine. Surgical resection is the treatment of choice.

Abdominal Pain

2018 ◽  
pp. 124-128
Author(s):  
Ali Kamran
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Emergency Department ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Key Management ◽  
Abdominal Ultrasound ◽  
Unclear Etiology

Small bowel obstruction is an important diagnosis to consider in an adult presenting with abdominal pain with previous risk factors. Abdominal pain of unclear etiology in the Emergency Department has an exhaustive differential, but key historical and physical exam findings can help narrow the differential considerably. Key management steps for a bowel obstruction include obtaining an appropriate history and physical examination, ordering necessary laboratory studies to exclude other diagnoses, making the patient nil per os, addressing any serious electrolyte derangements, obtaining necessary imaging and a surgical consult. Multidetector computed tomography of the abdomen provides the highest sensitivity for the diagnosis of a small bowel obstruction, but an abdominal X-ray or an abdominal ultrasound can be utilized to help make the diagnosis.

scholarly journals A case of idiopathic myointimal hyperplasia of the mesenteric veins presenting with small bowel obstruction

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kohei Yamada ◽  
Masatsugu Hiraki ◽  
Toshiya Tanaka ◽  
Daisuke Mori ◽  
Futoshi Tanaka ◽  
...  
Keyword(s):  
Small Intestine ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Bowel Disease ◽  
Smooth Muscles ◽  
Final Diagnosis ◽  
Mesenteric Veins ◽  
Ischemic Bowel

Abstract Background Idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV) is a rare ischemic bowel disease with venous occlusion resulting from the proliferation of smooth muscles in the venous intima. In most patients, the disease affects rectosigmoid colon and causes persistent abdominal pain and hematochezia, which is similar to inflammatory bowel disease (IBD). In addition, it is difficult to make a precise diagnosis of IMHMV without surgery. Case presentation An 81-year-old woman was admitted to our hospital with mild abdominal pain, nausea and vomiting. Repeated adhesive ileus was suspected due to the previous open and laparoscopic surgeries. Surgery was planned to treat small bowel obstruction. Intraoperatively no adhesive lesions were observed. However, a mass lesion was seen at the terminal ileum, which was suspected to have caused her bowel obstruction. Partial resection of the small intestine was performed. Macroscopic and histopathological examinations of the excised specimen showed circumferential ulceration with scarring, a thickened venous wall with active inflammation, and fibrotic changes that consequently produced stenosis and obstruction of the venous lumen in the subserosa. Additionally, Elastica van Gieson staining demonstrated thickening of the venous intima. The final diagnosis was IMHMV. At two years and 8 months after the operation, the patient was well without any additional medication. Conclusion IMHMV of the small intestine is rare. We described a case of IMHMV that was associated with ileus.

scholarly journals Point-of-care ultrasonography for the diagnosis of small bowel obstruction in the emergency department

CJEM ◽  
2015 ◽  
Vol 17 (2) ◽  
pp. 206-209 ◽  
Author(s):  
Joshua Guttman ◽  
Michael B. Stone ◽  
Heidi H. Kimberly ◽  
Joshua S. Rempell
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Acute Abdominal Pain ◽  
Point Of Care ◽  
Plain Radiography ◽  
Common Cause ◽  
Point Of Care Ultrasonography

AbstractSmall bowel obstruction (SBO) is a common cause of acute abdominal pain presenting to the emergency department (ED). Although the literature is limited, point-of-care ultrasonography (POCUS) has been found to have superior diagnostic accuracy for SBO compared to plain radiography; however, it is rarely used in North America for this. We present the case of a middle-aged man who presented with abdominal pain where POCUS by the emergency physician early in the hospital course expedited the diagnosis of SBO and led to earlier surgical consultation. The application of POCUS for SBO is easily learned and applied in the ED. POCUS for SBO may obviate the need for plain radiography and expedite patient care.

scholarly journals Gallstone ileus: a rare cause of small intestine obstruction

2021 ◽  
Author(s):  
Levan Tchabashvili ◽  
Dimitris Kehagias ◽  
Charalampos Kaplanis ◽  
Elias Liolis ◽  
Ioannis Perdikaris ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Small Intestine ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Emergency Surgery ◽  
Gallstone Ileus

A 77-year-old woman was admitted to our emergency department complaining of abdominal pain. Computed tomography was performed and showed aerobilila and a large 5.1 cm gallstone lodged in the small intestine. She underwent emergency surgery. Intraoperative findings noted small bowel obstruction caused by a large gallstone.

scholarly journals Intraluminal Apple as a Rare Cause of Small Bowel Obstruction

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Koichi Inukai ◽  
Akihiro Usui ◽  
Motohiko Yamada ◽  
Koji Amano ◽  
Nobutaka Mukai ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Sexual Behavior ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Preoperative Diagnosis ◽  
Foreign Bodies ◽  
Medical Attention ◽  
Sense Of Shame

Small bowel obstruction due to ingested foreign bodies is rare in adults. A 48-year-old male visited our hospital with abdominal pain and vomiting. Computed tomography revealed intestinal obstruction by a 3 × 4 cm apple-shaped foreign body. Emergency surgery was performed to clear the obstruction which, upon inspection, was caused by a sexual toy made of rubber. Flexible rubber products that are ingested should be carefully followed after they pass thorough the pylorus. For obstructions related to sexual behavior, the patient’s sense of shame often delays the process of seeking medical attention, thereby making preoperative diagnosis difficult.

scholarly journals Multiple Small Intestine Ulcers with Desquamation of the Fingers

2017 ◽  
Vol 11 (2) ◽  
pp. 452-461
Author(s):  
Azusa Kawasaki ◽  
Kunihiro Tsuji ◽  
Hisashi Doyama
Keyword(s):  
Computed Tomography ◽  
Small Intestine ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Yersinia Pseudotuberculosis ◽  
Oral Ulcers ◽  
Palmar Erythema ◽  
Antibody Titers ◽  
Endoscopic Characteristics ◽  
Multiple Ulcers

A 73-year-old female was admitted to our hospital with abdominal pain and diarrhea. Computed tomography detected distension of the small intestine. A palmar erythema, multiple oral ulcers, and desquamation of the fingers appeared after hospitalization. Small-bowel endoscopic images showed multiple ulcers. We attributed this case to infection with Yersinia pseudotuberculosis based on the changes in Y. pseudotuberculosis antibody titers throughout the course of the illness. This report is valuable, as it illustrates the endoscopic characteristics of a Y. pseudotuberculosis infection with skin lesion and ileus, which may enable us to deepen the pathologic understanding of this disease.

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