Application Effect of Comprehensive Nursing Intervention on the Treatment of Inflammatory Bowel Disease Complicated with Hemorrhage by Digestive Endoscopy under Multi-slice Spiral CT Enterography

Objective. To study the nursing effect of comprehensive nursing intervention on patients with inflammatory bowel disease (IBD) complicated with hemorrhage undergoing digestive endoscopy under multi-slice spiral CT enterography (MSCTE). Methods. The clinical data of 100 IBD patients complicated with hemorrhage undergoing digestive endoscopy under MSCTE in our hospital (February 2018-August 2019) were retrospectively analyzed. They were split into group X and group Y by coin throwing method, with 50 cases in each group. Group Yadopted routine nursing mode while group Xadopted comprehensive nursing intervention to compare the nursing efficiency, nursing satisfaction, incidence of adverse reactions, VAS pain score, QLI (life quality) score and PSQI (sleep quality) score between the two groups. Results. The nursing efficiency and nursing satisfaction in group X were obviously higher compared withgroup Y. After nursing, the incidence of adverse reactions in group X was obviously lower compared withgroup Y, with a statistically significant difference. After nursing, the VAS pain score in group X was obviously lower compared withgroup Y. After nursing, the QLI score in group X was obviously higher compared withgroup Y. After nursing, the PSQI in group X was obviously lower compared withgroup Y. Conclusion. Comprehensive nursing intervention is able to obviously improve nursing efficiency and nursing satisfaction, obviously reduce the possibility of adverse reactions in the nursing process, and improve the life quality score, sleep quality score and pain score, which has high application value in IBD patients complicated with hemorrhage treated by digestive endoscopy under MSCTE.

Role of Computed Tomography (CT) Enterography in the Evaluation of Small Bowel Diseases

BACKGROUND Small bowel imaging often questions clinicians due to its long, tortuous and undulating morphology. The current study was undertaken to establish the efficacy of multidetector computed tomography (MDCT) enterography in the evaluation of small bowel diseases using iso-osmotic mannitol as oral contrast agent. METHODS A prospective observational study was conducted among thirty patients (mean age 40 years; range 14 - 66 years), 16 males and 14 females presenting with clinical suspicion of small bowel diseases based on clinical, laboratory or other imaging investigations underwent CT enterography on a 128 slice CT scanner using isoosmotic mannitol as neutral enteral contrast. RESULTS Intestinal tuberculosis was the most common diagnosis. Non neoplastic cases predominantly showed segmental symmetrical involvement with target pattern of enhancement. Small bowel tumours (adenocarcinoma) were seen in 2 cases. Neoplasms were associated with focal asymmetrical involvement with heterogeneous enhancement pattern. Computerized tomography enterography (CTE) clearly depicted the site, level and cause of the obstruction in all the patients with a sensitivity and specificity of 96 % and 100 % respectively. Diagnostic accuracy of CTE in detection of small bowel diseases came out to be 98 %. CONCLUSIONS CT enterography is an effectual, non-invasive, well-tolerated, sensitive and specific imaging modality for the evaluation of small bowel diseases which provides superior assessment of the intraluminal, mural and extraintestinal pathologies. KEY WORDS CT enterography, mannitol, Tuberculosis, Small Bowel

Diagnostic role of computed tomography enterography (CTE) in assessment of intra-mural and extra-intestinal CT findings in active Crohn’s disease (CD)

Background Crohn’s disease (CD) is a ruinous bowel disease, which, if left uncured, leads to penetrating bowel complications. Computed tomography enterography (CTE) is nowadays accepted as a principal modality for the assessment of small bowel diseases. The aim of this study is to assess the role of CT enterography in the identification of intramural as well as extra-intestinal CT changes yielding more thorough data about the level and severity of the disease process thus planning appropriate treatment strategy. Results From March 2017 to January 2019, 50 patients in Cairo, Egypt, who had clinical manifestations of inflammatory bowel disease, were evaluated by MDCTE. CT image analysis was processed, including anatomical localization of bowel segments affection, assessment of mucosal thickening and hyper-enhancement, and extra-enteric affection. Diagnosis of Crohn’s disease (CD) was confirmed by endoscopy and histopathology; mucosal thickening was seen in 42 patients (84%), mucosal hyper-enhancement was seen in 44 patients (88%) while engorgement of vasa recta (comb’s sign) was seen in 38 patients (76%). Conclusion Although ileocolonoscopy is a proven sensitive method to detect mucosal injury and diagnose disease activity, it is limited by its maximal extent and inability to detect transmural complications as well as limited ability to assess deep bowel wall involvement. CT enterography (CTE) is a valuable technique in diagnostic evaluation of intramural and extra-intestinal involvement in Crohn’s disease (CD) during disease activity.