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Gastrointestinal Inflammation

Gastrointestinal Inflammation. Gastrointestinal Inflammation . Mucosal changes Indirect evaluation in most cases Evaluate lumen and effect on lumen Degree of mucosal involvement determines the imaging findings Superficial – little effect Penetrating – affect adjacent areas.

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Gastrointestinal Inflammation

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  1. Gastrointestinal Inflammation

  2. Gastrointestinal Inflammation • Mucosal changes • Indirect evaluation in most cases • Evaluate lumen and effect on lumen • Degree of mucosal involvement determines the imaging findings • Superficial – little effect • Penetrating – affect adjacent areas

  3. Gastrointestinal Inflammation • Superficial process • Little imaging finding • Spasm • Mucosal edema and irregularity • Penetrating process • Ulcer development • Perforation • Adjacent inflammatory process

  4. Ulcer In Stomach Wall • Silhouette • Extension of barium outside of the expected wall

  5. Gastric Ulcer • Barium projection from lesser curve – ulcer crater (arrow) • Line of edema (arrowheads)

  6. Gastric Ulcer * • Overhead film with ulcer on greater curve (arrows) • Lucent halo of edema base of ulcer (arrowhead) • Ulcer extends outside expected mucosal margin • Incidental note of contrast in gallbladder (*)

  7. Pyloric Channel Ulcer • Spot film • Projection of barium from pyloric channel • Edematous halo

  8. Post-bulbar Doudenal Ulcer • Barium collection just beyond the duodenal bulb greater curve aspect (large arrow) • Probable small ulcer lesser curve aspect as well (small arrow)

  9. Inflammatory Lesions of the Colon • Diverticulosis and Diverticulitis • Ulcerative colitis • Regional enterocolitis (Crohn’s disease)

  10. Inflammatory Lesions of the Colon • Appearance • Narrowing due to spasm, stricture, extrinsic mass • Dilatation resulting from partial/ complete obstruction • Mucosal changes: edema, hypertrophy, ulceration, etc.

  11. Diverticulosis, Diverticulitisand their complications • Diverticula • Mucosa protrudes out of bowel lumen through a weak point in muscle layer • Diverticulosis • Multiple diverticula

  12. Diverticulosis, Diverticulitisand their complications • Diverticulitis • Complication of diverticulosis • Penetrating inflammatory process • Causes perforation of diverticulum • Inflammatory process usually localized and forms pericolic abscess • Can develop fistulas to vagina, bladder, etc.

  13. Diverticulosis • Single contrast barium enema • Multiple outpouchings representing diverticula • More prominent descending and sigmoid colon

  14. Diverticulitis • Oblique film • Extravasation from lumen • Abscess cavity with barium

  15. CT of Diverticulitis • Inflammatory process in the mesentery (diffuse gray area) with air collections (arrows)

  16. Diverticulitis –CT Scanning

  17. Appendicitis / Appendicolith • Calcific density RLQ

  18. Appendicitis • CT is useful study • Irregular gray density represents inflammatory change in the RLQ in the area of the appendix • May see stone in appendix

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