Rg2A Small Bowel Studies

Front 1

Example of barium Follow through

Back 1

Front 2

Example of small bowel enema

Back 2

Front 3

What is malabsorption?

Back 3

Abnormal absorption of fat, water, protein, carbohydrates from small bowel

Front 4

Radiographic features of malabsorption:

Back 4

•Dilatation of bowl loops
•Diluted barium (mixes with watery bowel
content)
•Flocculated barium : barium aggregates
into particles (mainly seen with older
barium suspensions, rarely occurs with
new agents)
•Slow transit
•Segmentation of barium (lack of
continuous column)
•Moulage pattern: featureless barium
collection
•Hidebound pattern: valvulae thinner,
closer together, wrinkled looking

Front 5

What is Coeliac Sprue?

Back 5

Its is a disease hat affects the mucosa of the small bowel and the submucosa, muscularis and serosa are usually intact.
it is hereditary with genetic transmission of an inborn error or metabolism

Front 6

What are common symptoms of coeliac sprue?

Back 6

diarrhoea, flatulence, weight loss and weakness

Front 7

Radiographic features of coeliac sprue:

Back 7

•dilatation of small bowel is the most typical finding
•Segmentation
•Moulage sign: rare
•Transient intussusceptions (coiled
spring) are typical
•Decreased fold pattern of jejunum
•Prominent ileal fold pattern (ileum
appears like jejunum)
•Increased secretions: flocculation
with older barium suspensions
•Increased incidence of malignancy,
aggressive lymphoma, carcinoma

Front 8

Characteristic image of malabsorption

Back 8

Front 9

Fissure ulcer - a characteristic of Chrohn's disease

Back 9

Front 10

Radiographic features: types of lesions

Back 10

– Thickening of folds
– Nodular pattern
– String sign: tubular narrowing of intestinal lumen

Front 11

Radiographic features: ulceration

Back 11

– Aphthoid ulcers are early lesions & correspond to mucosal erosions
– Ulcers are irregularly scattered through out GI tract & are interspersed with normal
mucosa
– Ulcerations grow and fuse with each other in linear fashion and with intervening
oedematous mucosa

Front 12

Radiographic features: Crohn’s disease at advanced stages

Back 12

Fatty thickening and/or retraction of the mesentery, mass effect may separate bowel loops or make loops display a concentric shape

Front 13

Radiographic features: Fibrosis and scarring may result in

Back 13

– Pseudodiverticula
– Rigid, featureless bowel
– Stricutres and obstruction
– Foreshortening of bowel

Front 14

Complications of Chrohn's Disease (RIFTA)

Back 14

-Recurrence (after surgery)
-incresed incidence of malignancies (lymphoma, GIT tumours)
-toxic megacolon
-fistulas
abscess formation