Celiac disease other imaging findings: Difference between revisions

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VisualWikitext

Latest revision as of 20:50, 29 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]

Overview

Features of small bowel barium studies are not sensitive enough for definite diagnosis, but the following changes may be seen: Small intestinal dilatation due to excess fluid, dilution of contrast, multiple non-obstructing intussusceptions, jejunoileal fold pattern reversal, moulage sign, mosaic pattern, flocculation, and segmentation.

Other Imaging findings

Fluoroscopy

Features of small bowel barium studies are not sensitive enough for confident diagnosis, but the following changes may be seen:^[1]

Small intestinal dilatation due to excess fluid
Dilution of contrast
Multiple non-obstructing intussusceptions
Jejunoileal fold pattern reversal
Moulage sign : A dilated jejunal loop with complete loss of jejunal folds
Mosaic pattern
Flocculation
Segmentation

References

↑ Sheedy SP, Barlow JM, Fletcher JG, Smyrk TC, Scholz FJ, Codipilly DC, Al Bawardy BF, Fidler JL (2017). "Beyond moulage sign and TTG levels: the role of cross-sectional imaging in celiac sprue". Abdom Radiol (NY). 42 (2): 361–388. doi:10.1007/s00261-016-1006-2. PMID 28154909.

Template:WH Template:WS

[pmid28154909-1] Sheedy SP, Barlow JM, Fletcher JG, Smyrk TC, Scholz FJ, Codipilly DC, Al Bawardy BF, Fidler JL (2017). "Beyond moulage sign and TTG levels: the role of cross-sectional imaging in celiac sprue". Abdom Radiol (NY). 42 (2): 361–388. doi:10.1007/s00261-016-1006-2. PMID 28154909.

[1]

@@ Line 1: / Line 1: @@
 __NOTOC__
 {{Celiac disease}}
-{{CMG}}
+{{CMG}}; {{AE}} {{MIR}}
 ==Overview==
+Features of [[small bowel]] barium studies are not sensitive enough for definite diagnosis, but the following changes may be seen: [[Small intestine|Small intestinal]] dilatation due to excess fluid, [[dilution]] of contrast, multiple non-obstructing [[Intussusception|intussusceptions]], jejunoileal fold pattern reversal, moulage sign, mosaic pattern, [[flocculation]], and [[segmentation]].
 ==Other Imaging findings==
-===Endoscopy===
-[[Image:celiac_3.jpg|left|thumb|200px|[[Endoscopy|Endoscopic]] still of [[duodenum]] of patient with coeliac disease showing scalloping of folds.]]
-An [[upper endoscopy]] with [[biopsy]] of the [[duodenum]] (beyond the [[duodenal bulb]]) or [[jejunum]] is performed. It is important for the physician to obtain multiple samples (four to eight) from the duodenum. Not all areas may be equally affected; if biopsies are taken from healthy bowel, it would result in false negative results.<ref name=AGA/>
-Most patients with coeliac disease have a small bowel that appears normal on endoscopy; however, five endoscopic findings have been associated with a high specificity for coeliac disease when all are found: scalloping of the small bowel folds (''pictured''), paucity in the folds, a mosaic pattern to the [[mucosa]] (described as a ''cracked-mud'' appearance), prominence of the submucosal blood vessels and a nodular pattern to the mucosa.<ref>{{cite journal | author = Niveloni S, Fiorini A, Dezi R, Pedreira S, Smecuol E, Vazquez H, Cabanne A, Boerr LA, Valero J, Kogan Z, Maurino E, Bai JC. | title = Usefulness of videoduodenoscopy and vital dye staining as indicators of mucosal atrophy of celiac disease: assessment of interobserver agreement | journal = Gastrointestinal Endoscopy | volume = 47 | issue = 3 | pages = 223–229 | year = 1998 | id = PMID 9580349}}</ref>
+==== Fluoroscopy ====
+Features of [[small bowel]] barium studies are not sensitive enough for confident diagnosis, but the following changes may be seen:<ref name="pmid28154909">{{cite journal |vauthors=Sheedy SP, Barlow JM, Fletcher JG, Smyrk TC, Scholz FJ, Codipilly DC, Al Bawardy BF, Fidler JL |title=Beyond moulage sign and TTG levels: the role of cross-sectional imaging in celiac sprue |journal=Abdom Radiol (NY) |volume=42 |issue=2 |pages=361–388 |year=2017 |pmid=28154909 |doi=10.1007/s00261-016-1006-2 |url=}}</ref>
-Until the 1970s, biopsies were obtained using metal capsules attached to a suction device. The capsule was swallowed and allowed to pass into the small intestine. After X-ray verification of its position, suction was applied to collect part of the intestinal wall inside the capsule. One much utilized capsule system is the [[Watson capsule]]. This method has now been largely replaced by fiberoptic endoscopy, which carries a higher sensitivity rate and a lower error frequency.<ref>{{cite journal |author=Mee A, Burke M, Vallon A, Newman J, Cotton P |title=Small bowel biopsy for malabsorption: comparison of the diagnostic adequacy of endoscopic forceps and capsule biopsy specimens |journal=Br Med J (Clin Res Ed) |volume=291 |issue=6498 |pages=769-72 |year=1985 |pmid=3929934}}</ref>
+* [[Small intestine|Small intestinal]] dilatation due to excess fluid
+* [[Dilution]] of contrast
+* Multiple non-obstructing [[Intussusception|intussusceptions]]
+* Jejunoileal fold pattern reversal
+* Moulage sign : A dilated jejunal loop with complete loss of jejunal folds
+* Mosaic pattern
+* [[Flocculation]]
+* [[Segmentation]]
 ==References==
 {{reflist|2}}
 {{WH}}
 {{WS}}
+[[Category:Gastroenterology]]
+[[Category:Rheumatology]]
+[[Category:Autoimmune diseases]]
+[[Category:Genetic disorders]]
+[[Category:Malnutrition]]
+[[Category:Pediatrics]]
+[[Category:Dermatology]]
+[[Category:Up-To-Date]]