Abdominal Ultrasonogram in Typhoid Fever: A Useful Diagnostic Tool

Objectives: To See the use of abdominal ultrasonogrphic in the diagnosis of Typhoid fever.Materials and Methods: This cross sectional study on enteric fever was carried out during the period of July 2008 to June 2009 on 30 patients between 2 months 12 years of age of either sex admitted with the clinical diagnosis of enteric fever having positive hemoculture for Salmonella typhi or paratyphi and or significant Widal test. Abdominal USG was done at Centre for Nuclear Medicine and Ultrasound, Bangladesh atomic energy commission, Sir Salimullah Medical College & Mitford Hospital.Result: On ultrasonogram, hepatomegaly observed in 93.3% cases, splenomegaly in 53.3% cases, thickened bowel wall in 46.7% cases, enlarged mesenteric lymph node in 63.3% cases and 30% cases showed gall bladder changes. Ultrasonogram was done on first week of fever in 33.3% cases, on second week in 43.3% cases and third week in 23.3% cases. Out of them ultrasonogram done on first day of admission in 6.6% cases, on second day in 80% cases and third day in 13.3% cases. In first week the bowel wall thickening found in 10% cases, lymph node enlargement in 23.3% cases and gall bladder changes in 3.3% cases, in second week the bowel wall thickening found in 23.3% cases, lymph node enlargement in 26.6% cases and gall bladder changes in 20% cases, in third week the bowel wall thickening found in 13.3% cases, lymph node enlargement in 13.3% cases and gall bladder changes in 6.6% cases. Sonologic findings of bowel wall thickening, lymph node enlargement and gall bladder changes found in 23.33% cases in 1st week, 33.33% cases in 2nd week and 13.33% cases in 3rd week.Conclusion: In endemic areas like Bangladesh ultrasound findings of hepatomegaly, splenomegaly, mesenteric lymphadenopathy, bowel wall thickening, gall bladder changes are useful diagnostic features of typhoid fever.J. Paediatr. Surg. Bangladesh 5(2): 58-63, 2014 (July)

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Abdominopelvic actinomycosis: spectrum of imaging findings and common mimickers

Acta Radiologica Short Reports ◽

10.1177/2047981614524570 ◽

2014 ◽

Vol 3 (2) ◽

pp. 204798161452457 ◽

Cited By ~ 2

Author(s):

Charikleia Triantopoulou ◽

Aart Van der Molen ◽

Ad CMG Van Es ◽

Maria Giannila

Keyword(s):

Bowel Wall ◽

Pelvic Mass ◽

Wall Thickening ◽

Inflammatory Infiltration ◽

Cross Sectional ◽

Contraceptive Devices ◽

Intrauterine Contraceptive ◽

Cross Sectional Imaging ◽

Bowel Wall Thickening ◽

Intrauterine Contraceptive Devices

Background Actinomycosis is a rare suppurative disease that may mimic other inflammatory conditions on imaging. Its invasive nature may lead to mass formation and atypical presentation thus making accurate diagnosis quite difficult. Purpose To describe the different aspects of abdominopelvic actinomycosis on cross-sectional imaging and indicate discriminative findings from other inflammatory or neoplastic diseases. Material and Methods In our study we analyzed 18 patients (15 women, 3 men; age range, 25–75 years; mean age, 50 years) with pathologically proved abdominopelvic actinomycosis. Contrast-enhanced abdominal computed tomography (CT) had been performed in all patients. Eleven patients had a history of using intrauterine contraceptive devices. Bowel site, wall thickness and enhancement degree, inflammatory infiltration, and features of peritoneal or pelvic mass were evaluated at CT. Results The sigmoid colon was most commonly involved. Most patients showed concentric bowel wall-thickening, enhancing homogenously and inflammatory infiltration of pericolonic fat was mostly diffuse. In 11 patients, one or more pelvic abscesses were revealed, while a peritoneal or pelvic mass adjacent to the involved bowel segment was seen in three cases. Infiltration into the abdominal wall was seen in three cases while in one case there was thoracic dissemination. Conclusion Actinomycosis is related not only to long-term use of intrauterine contraceptive devices and should be included in the differential diagnosis when cross-sectional imaging studies show concentric bowel wall-thickening, intense contrast enhancement, regional pelvic or peritoneal masses, and extensive inflammatory fat infiltration with abscess formation.

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Role of Multidetector Computed Tomography in Patients of Acute Mesenteric Ischaemia and its Comparison with Clinicosurgical Outcome: A Cross-sectional Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/49524.15126 ◽

2021 ◽

Author(s):

Narinder Salhotra ◽

Ritu Dhawan ◽

Anisha Galhotra ◽

Arnav Galhotra ◽

Chandan Kakkar ◽

...

Keyword(s):

Computed Tomography ◽

Bowel Wall ◽

Pneumatosis Intestinalis ◽

Wall Thickening ◽

Mesenteric Ischaemia ◽

First Line ◽

Cross Sectional ◽

Acute Mesenteric Ischaemia ◽

Bowel Wall Thickening ◽

Bowel Dilatation

Introduction: Acute mesenteric ischaemia is an abdominal emergency occurring in nearly 1% of patients presenting with acute abdomen. Early diagnosis is very important for the improved survival of the patient. Acute mesenteric ischaemia frequently presents with non specific features such as vomiting, loose stools and abdominal distension. The classical triad of fever, haematochezia and abdominal pain is seen in only 30% of the patients so, it is difficult to diagnose clinically. Multidetector Computed Tomography (MDCT) is gold standard and first line test to diagnose intestinal ischaemia. Aim: To assess the efficacy of MDCT in the diagnosis of acute mesenteric ischaemia and to compare its outcome with surgical and/or clinical findings. Materials and Methods: In this cross-sectional descriptive study conducted from 1st November 2018 to 31st May 2020, MDCT was performed on 40 patients (23 male; 17 female, age range: 28-93 years). Axial and reconstructed images of each patient were evaluated for evidence of bowel wall thickening, bowel wall attenuation, abnormal wall enhancement, bowel dilatation, mesenteric stranding, ascites, solid organ infarcts, pneumatosis intestinalis or portomesenteric gas, and mesenteric arterial or venous thrombosis. Multidetector CT findings were compared with the surgical findings and clinical outcome. Results were expressed in terms of frequency and percentages. Results: Out of 40 patients, most common cause of acute mesenteric ischaemia was arterial thrombosis, seen in 20 patients (50%) while 13 patients (32.5%) had portomesenteric venous thrombosis and 7 (17.5%) patients were diagnosed with non occlusive mesenteric ischaemia. CT finding of bowel wall thickening and bowel dilatation however non specific were seen in majority of patients (62.5% and 70%, respectively). Mesenteric fat stranding and ascites were seen in 95% and 77.5% cases respectively. Specific signs of acute mesenteric ischaemia includes hypoenhancing and non enhancing bowel walls seen in 27 patients (67.5%). Pneumatosis intestinalis and portomesenteric pneumatosis in 20% patients. A total of 27 patients underwent surgery and 13 patients were managed conservatively. On comparing the CT findings with intraoperative/ histopathological findings, accuracy of MDCT in the diagnosis of acute mesenteric ischaemia in this study was 96.39%. Conclusion: MDCT should be the first line imaging modality to diagnose acute mesenteric ischaemia and to exclude other causes of acute abdomen. It is an excellent and fast modality to diagnose bowel ischaemia, as it can visualise both the bowel and mesenteric changes as well as accurately depict the mesenteric vasculature.

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Correlation of Bowel Wall Thickening Seen Using Computerized Tomography With Colonoscopies

Surgical Laparoscopy Endoscopy & Percutaneous Techniques ◽

10.1097/sle.0000000000000389 ◽

2017 ◽

Vol 27 (3) ◽

pp. 154-157 ◽

Cited By ~ 6

Author(s):

Arda Isik ◽

Mehmet Soyturk ◽

Sakir Süleyman ◽

Deniz Firat ◽

Kemal Peker ◽

...

Keyword(s):

Computerized Tomography ◽

Bowel Wall ◽

Wall Thickening ◽

Bowel Wall Thickening

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CT Evaluation of Target-like Bowel Wall Thickening

Journal of the Korean Radiological Society ◽

10.3348/jkrs.1997.36.2.271 ◽

1997 ◽

Vol 36 (2) ◽

pp. 271

Author(s):

In Young Bae ◽

Mi Young Kim ◽

Chang Hea Suh ◽

Soon Gu Cho ◽

Jin Hee Kim ◽

...

Keyword(s):

Bowel Wall ◽

Wall Thickening ◽

Ct Evaluation ◽

Bowel Wall Thickening

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Significance of Bowel Wall Thickening on Computed Tomography Scan: Higher Risk of Pathology Among African Americans Compared to Hispanics

Journal of the National Medical Association ◽

10.1016/s0027-9684(15)30882-8 ◽

2009 ◽

Vol 101 (4) ◽

pp. 345-348 ◽

Cited By ~ 2

Author(s):

Pikeshkumar Patel ◽

David Widjaja ◽

Steve Blum ◽

Mariela Glandt ◽

jagadish Akella ◽

...

Keyword(s):

Computed Tomography ◽

African Americans ◽

Bowel Wall ◽

Wall Thickening ◽

Computed Tomography Scan ◽

Bowel Wall Thickening ◽

Tomography Scan

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Segmental or Diffuse Small Bowel Wall Thickening

Expertddx: Abdomen and Pelvis ◽

10.1016/b978-0-323-44287-9.50049-8 ◽

2017 ◽

pp. 148-153

Keyword(s):

Small Bowel ◽

Bowel Wall ◽

Wall Thickening ◽

Bowel Wall Thickening

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Epiploic Appendagitis: An Often Misdiagnosed Cause of Acute Abdomen

Case Reports in Gastroenterology ◽

10.1159/000502683 ◽

2019 ◽

Vol 13 (3) ◽

pp. 364-368

Author(s):

Vishnu Charan Suresh Kumar ◽

Kishore Kumar Mani ◽

Hisham Alwakkaa ◽

James Shina

Keyword(s):

Abdominal Pain ◽

Bowel Wall ◽

Acute Diverticulitis ◽

Lower Abdominal Pain ◽

Wall Thickening ◽

Antibiotic Administration ◽

Epiploic Appendagitis ◽

High Attenuation ◽

History Of ◽

Bowel Wall Thickening

Epiploic appendages are peritoneal structures that arise from the outer serosal surface of the bowel wall towards the peritoneal pouch. They are filled with adipose tissue and contain a vascular stalk. Epiploic appendagitis is a rare cause of acute lower abdominal pain. It most commonly results from torsion and inflammation of the epiploic appendages, and its clinical features mimic acute diverticulitis or acute appendicitis resulting in being often misdiagnosed as diverticulitis or appendicitis. This frequently leads to unnecessary hospitalization, antibiotic administration, and unwarranted surgeries. Epiploic appendagitis is usually diagnosed with CT imaging, and the classic CT findings include: (i) fat-density ovoid lesion (hyperattenuating ring sign), (ii) mild bowel wall thickening, and (iii) a central high-attenuation focus within the fatty lesion (central dot sign). It is treated conservatively, and symptoms typically resolve in a few days. Therefore, epiploic appendagitis should be considered as one of the differential diagnosis for acute lower abdominal pain and prompt diagnosis of epiploic appendagitis can avoid unnecessary hospitalization and surgical intervention. In this case report, we discuss a 72-year-old woman who presented with a 2-day history of acute left lower abdominal pain.

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Giant villous adenoma of the sigmoid colon: an unusual cause of homogeneous, segmental bowel wall thickening

BJR|case reports ◽

10.1259/bjrcr.20200016 ◽

2020 ◽

Vol 6 (4) ◽

pp. 20200016

Author(s):

Jeffrey Sacks ◽

Seymour Atlas ◽

Alar Enno ◽

Leonardo Santos ◽

Jeremy Humphries ◽

...

Keyword(s):

Colorectal Cancer ◽

Sigmoid Colon ◽

Malignant Transformation ◽

Villous Adenoma ◽

Bowel Wall ◽

Wall Thickening ◽

Colonic Adenomas ◽

Bowel Wall Thickening ◽

Villous Adenomas

Colonic adenomas are commonly encountered lesions that are a precursor of colorectal cancer. Of these, villous adenomas are a rarer, more advanced subtype that are larger in size than tubular adenomas and have a higher risk of malignant transformation. We present a patient with a giant villous adenoma of the sigmoid colon identified on CT as homogeneous segmental bowel wall thickening.

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Chronic Active Epstein-Barr Virus-Associated Enteritis: CT Findings and Clinical Manifestation

BioMed Research International ◽

10.1155/2020/2978410 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Bo Zhang ◽

Xia Wang ◽

Xiaoyan Tian ◽

Yongping Cai ◽

Xingwang Wu

Keyword(s):

Epstein Barr Virus ◽

Bowel Wall ◽

Clinical Symptoms ◽

Wall Thickening ◽

Barr Virus ◽

Ct Findings ◽

Pathologic Findings ◽

Bowel Wall Thickening ◽

Epstein Barr ◽

Fat Stranding

Aim. To improve the identification and computed tomography (CT) diagnostic accuracy of chronic active Epstein-Barr virus (EBV)-associated enteritis (CAEAE) by evaluating its CT findings and clinical manifestation. Methods. The data of three patients with pathologically and clinically confirmed CAEAE who underwent CT enterography (CTE) were retrospectively reviewed from January 2018 to October 2019. The following data were evaluated: imaging characteristics (length of involvement, pattern of mural thickening, pattern of attenuation, perienteric abnormalities), clinical symptoms, endoscopic records, laboratory examinations, and pathologic findings. Results. Based on CT findings, two patients demonstrated segmental bowel wall thickening (involvement length >6 cm), asymmetric thickening, layered attenuation, fat stranding, and adenopathy, whereas the remaining one had no positive finding. The endoscopic results of all patients showed numerous irregular ulcers in the colon, and one patient had a focal esophageal ulcer. The major clinical symptoms were abdominal pain (n=3), retrosternal pain (n=1), fever (n=3), diarrhea (n=2), hematochezia (n=1), and adenopathy (n=3). The main laboratory examination indicators were increased serum EBV DNA load (n=1) and increased inflammatory markers (n=3). With regard to the main pathologic findings, all patients showed positive EBV-encoded RNA (EBER) situ hybridization in the colonic biopsy specimen, with one patient being positive in the esophagus. Conclusion. CAEAE is rare and is usually misdiagnosed as inflammatory bowel disease (IBD). The imaging features of CAEAE overlap with those of Crohn’s disease and ulcerative colitis. The presence of segmental and asymmetric bowel wall thickening, layered attenuation, and fat stranding in the CTE image may be helpful in differentiating CAEAE from IBD.

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