RESUMO
Background: Congenital enterocolic fistula, an abnormal connection between the small intestine and the colon, is a rare condition with the potential for significant complications affecting the patient's quality of life. Case Report: A 2 year and 7 months old girl presented with abdominal pain and diarrhea lasting more than 10 days. The formation of the intestinal fistula was first detected by ultrasound, and the blood flow in the intestinal wall was preliminally analyzed. Surgical exploration revealed a colonic fistula formed by the attachment of the jejunum to the descending colon. Postoperatively, symptoms improved; no secondary infection occurred and the fistula healed well. Conclusion: Congenital colon fistula is rarely reported, and ultrasound is becoming more and more important in its diagnosis. Here, we report a case of congenital colonic fistula diagnosed by ultrasound. Ultrasound can dynamically and in real-time observe the intestinal condition, which is conducive to the early diagnosis and staging of congenital intestinal diseases and the determination of diagnosis and treatment schemes.
Assuntos
Enterocolite , Fístula Intestinal , Ultrassonografia , Humanos , Feminino , Ultrassonografia/métodos , Fístula Intestinal/diagnóstico por imagem , Pré-Escolar , Enterocolite/diagnóstico por imagemRESUMO
A 38-year-old man visited our hospital with a complaint of diarrhea and abdominal pain. Contrast-enhanced computed tomography showed that the ileocecal site was intussuscepted to the transverse colon without ischemia. After we reduced intussusception with an enema using a water-soluble contrast agent, his abdominal pain disappeared. Colonoscopy was performed immediately after reduction and showed erosion and edema at the ileocecal site without tumor. The stool culture at admission revealed verotoxin 1 producing Escherichia coli O-26;therefore, we established a diagnosis of intussusception associated with Escherichia coli enterocolitis. Bacterial enteritis should be considered as a potential cause in adult patients with intussusception.
Assuntos
Colo Transverso , Enterocolite , Intussuscepção , Adulto , Colonoscopia , Enterocolite/diagnóstico por imagem , Enterocolite/etiologia , Escherichia coli , Humanos , Intussuscepção/diagnóstico por imagem , Intussuscepção/etiologia , Intussuscepção/cirurgia , MasculinoRESUMO
PURPOSE: Immune checkpoint inhibitors promote the antitumor activity of T cells; however, there is a risk of side effects. The aim of this study was to characterize the computed tomography (CT) findings of one such side effect, anti-programmed cell death-1 antibody-related enterocolitis (αPD-1-EC). METHODS: This single-institution retrospective study included 21 patients with αPD-1-EC who underwent CT between January 2015 and April 2020. Two board-certified radiologists independently evaluated the CT findings, including the pattern of intestinal wall enhancement, maximum bowel wall thickness, maximum appendiceal diameter, and involvement of enterocolitis in each intestinal segment. Symptoms and their severity were also investigated. RESULTS: Pancolitis and skip lesions involving both the rectosigmoid colon and the cecum were found in 9 patients each (42.9%). The rectum was the most frequently involved lesion (18/21, 85.7%), and appendiceal involvement was found in 11 patients (52.4%). The most frequent wall enhancement pattern was the gray pattern (i.e., mild homogeneous enhancement of the thickened bowel wall). The mean maximum diameter of the involved appendix was 9.6 ± 4.5 mm (range 4.5-18 mm). Frequent symptoms included diarrhea (21/21), fever (8/21), and abdominal pain (7/21). Other concomitant immune-related adverse events were found in 6 patients. CONCLUSIONS: Pancolitis, skip lesions, and appendiceal involvement were frequent in patients with αPD-1-EC. When combining these characteristic findings with other clinical findings, such as low-grade diarrhea, other concomitant immune-related adverse events, and anti-PD-1 therapy administration, CT may be a useful diagnostic tool for αPD-1-EC.
Assuntos
Apêndice , Enterocolite , Enterocolite/induzido quimicamente , Enterocolite/diagnóstico por imagem , Humanos , Inibidores de Checkpoint Imunológico , Estudos Retrospectivos , Tomografia Computadorizada por Raios XAssuntos
Enterocolite/diagnóstico por imagem , Doenças Inflamatórias Intestinais/diagnóstico por imagem , Linfócitos , Flebite/diagnóstico por imagem , Idoso , Enterocolite/complicações , Enterocolite/cirurgia , Humanos , Doenças Inflamatórias Intestinais/complicações , Doenças Inflamatórias Intestinais/cirurgia , Masculino , Flebite/complicações , Flebite/cirurgiaRESUMO
An adult cat was presented for acute history of vomiting and collapse. Radiographs showed the presence of air within small intestinal walls and arborizing gas patterns within the liver, compatible with pneumatosis intestinalis and presumed portal venous gas, respectively. An abdominal ultrasound the following day was suggestive of gas within the intestinal wall, however, gas within the hepatic vasculature, parenchyma, or biliary tree was not evident. Due to progressive clinical deterioration of the patient, the owners elected humane euthanasia. Necropsy revealed severe necrotizing hemorrhagic enterotyphlocolitis secondary to Clostridium difficile toxin.
Assuntos
Doenças do Gato/diagnóstico por imagem , Intestino Delgado/diagnóstico por imagem , Pneumatose Cistoide Intestinal/veterinária , Animais , Doenças do Gato/microbiologia , Doenças do Gato/patologia , Gatos , Enterocolite/diagnóstico por imagem , Enterocolite/patologia , Enterocolite/veterinária , Feminino , Pneumatose Cistoide Intestinal/diagnóstico por imagem , Pneumatose Cistoide Intestinal/patologia , Veia Porta/diagnóstico por imagem , Radiografia/veterinária , Ultrassonografia/veterináriaRESUMO
BACKGROUND: Computed tomography (CT) is often used as the initial diagnostic test in patients with inflammatory and infectious types of enterocolitis. The differential diagnosis is broad, including infectious, non-infectious and vascular causes, which have substantially different management strategies. Although a definitive diagnosis often relies on endoscopic biopsy results, stool culture results or other clinical features, radiologists often help to guide the diagnosis. OBJECTIVES: This article reviews the CT appearance of different infectious and inflammatory forms of enterocolitis. General and specific intramural and extramural CT findings in the small bowel and colon are discussed. Added focus is placed on distribution patterns and medication side effects that can act as important diagnostic clues. RESULTS: Infectious enterocolitis is due to bowel inflammation caused by bacteria, viruses, or parasites, which show a preferential localization. Pancolitis can be seen with Clostridium difficile with the relatively specific CT finding of the "giraffe coat" sign. Inflammatory enterocolitis can be primary (inflammatory bowel disease, vasculitis) or secondary (radiation therapy, graft versus host disease etc.). Ischemic colitis and enteritis can result from arterial compromise, low flow states that globally reduce perfusion or venous insufficiency. The CT appearance varies depending on the cause, the time of onset and grade of reperfusion. CONCLUSION: Knowledge of characteristic mural and extramural CT of MRI findings, geographic distributions and therapy effects help to guide the differential diagnostics in inflammatory and infectious types of enterocolitis.
Assuntos
Enterocolite , Diagnóstico Diferencial , Enterocolite/diagnóstico por imagem , Humanos , Inflamação , Intestino Delgado , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios XAssuntos
Enterocolite/diagnóstico por imagem , Hipersensibilidade Alimentar/diagnóstico , Trato Gastrointestinal/patologia , Acidose/etiologia , Azotemia/etiologia , Diagnóstico Diferencial , Diarreia Infantil/etiologia , Enterocolite/etiologia , Feminino , Hipersensibilidade Alimentar/complicações , Humanos , Fórmulas Infantis , Recém-Nascido , Intestinos/diagnóstico por imagem , Intestinos/patologia , Radiografia , Vômito/etiologiaAssuntos
Inibidores da Angiogênese/efeitos adversos , Enterocolite/induzido quimicamente , Hemangiossarcoma/tratamento farmacológico , Pirimidinas/efeitos adversos , Sulfonamidas/efeitos adversos , Enterocolite/diagnóstico por imagem , Feminino , Humanos , Indazóis , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVES: Enterocolitis remains the most significant cause of morbidity and mortality in Hirschsprung disease (HD). It could progress into toxic megacolon (TM)-acute dilatation of the colon as accompanying toxic complication of Hirschsprung enterocolitis. It is a devastating complication, especially in infants with so far undiagnosed HD. METHODS: A retrospective analysis of medical records of 4 infants with TM was performed. The diagnosis TM was determined on the basis of clinical information (abdominal pain or tenderness, abdominal distension, diarrhea, bloody diarrhea, and constipation), plain x-rays of the abdomen (segmental or total colonic dilation), and the presence of such criteria (fever, high heart rate, increased white blood cell count, C reactive protein, anemia, dehydration, electrolyte disturbances, hypotension). Surgical management and outcome was evaluated by retrospective chart review. RESULTS: The median duration of symptoms characteristic for TM was 3 days. Toxic megacolon was seen as the first manifestation of previously unknown HD in 3 patients; in 1 newborn, the contrast radiograph was suggestive of HD. In all patients, conservative treatment was failed. Three patients were treated with surgical decompression and ileostomy only. In all these cases, severe complications occurred, consequently 2 of them died. In 1 patient, a resection of the transverse dilated colon additionally was performed. This patient had no complications in postoperative period and survived. CONCLUSIONS: Because of the high mortality in patients with TM that were treated medically or with colonic decompression, a resection of massively distended part of the colon should be performed.
Assuntos
Enterocolite/cirurgia , Doença de Hirschsprung/cirurgia , Megacolo Tóxico/cirurgia , Enterocolite/diagnóstico por imagem , Evolução Fatal , Doença de Hirschsprung/diagnóstico por imagem , Humanos , Lactente , Recém-Nascido , Masculino , Megacolo Tóxico/diagnóstico por imagem , Megacolo Tóxico/etiologia , Estudos RetrospectivosAssuntos
Infecções por Campylobacter/diagnóstico por imagem , Cólica/diagnóstico por imagem , Cólica/etiologia , Diarreia/diagnóstico por imagem , Diarreia/etiologia , Diverticulite/diagnóstico por imagem , Enterocolite/diagnóstico por imagem , Náusea/diagnóstico por imagem , Náusea/etiologia , Tiflite/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , UltrassonografiaRESUMO
Typhoid fever is a major health problem in many developing countries and its clinical features are similar to other types of bacterial enterocolitis. Definitive diagnosis by blood culture requires several days and is often unfeasible to perform in developing countries. More efficient and rapid diagnostic methods for typhoid are needed. We compared the pathological changes in the bowel and adjacent tissues of patients having typhoid fever with those having bacterial enterocolitis using ultrasonography. A characteristic of patients with non-typhoidal Salmonella and Campylobacter jejuni enterocolitis was mural thickening of the terminal ileum; only mild mural swelling or no swelling was observed in patients with typhoid fever. Mesenteric lymph nodes in patients with typhoid fever were significantly more enlarged compared to patients with other types of bacterial enterocolitis. Our findings suggest typhoid fever is not fundamentally an enteric disease but rather resembles mesenteric lymphadenopathy and ultrasound is a promising modality for diagnosing typhoid fever in developing countries.
Assuntos
Febre Tifoide/diagnóstico por imagem , Adolescente , Infecções por Campylobacter/diagnóstico por imagem , Infecções por Campylobacter/epidemiologia , Campylobacter jejuni , Criança , Pré-Escolar , Enterocolite/diagnóstico por imagem , Enterocolite/epidemiologia , Enterocolite/microbiologia , Feminino , Humanos , Masculino , Paquistão/epidemiologia , Infecções por Salmonella/diagnóstico por imagem , Infecções por Salmonella/epidemiologia , Febre Tifoide/epidemiologia , Ultrassonografia , Adulto JovemRESUMO
We describe a case of Clostridium septicum enterocolitis in a patient with pre-B acute lymphoblastic leukaemia undergoing autologous stem cell transplant. In the setting of neutropenia, Clostridium septicum should be suspected in patients who develop signs and symptoms of acute abdomen.
Assuntos
Infecções por Clostridium/complicações , Enterocolite/microbiologia , Neutropenia/microbiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras B/complicações , Abdome Agudo , Adulto , Infecções por Clostridium/diagnóstico por imagem , Enterocolite/diagnóstico por imagem , Evolução Fatal , Humanos , Hospedeiro Imunocomprometido , Masculino , Leucemia-Linfoma Linfoblástico de Células Precursoras B/terapia , Transplante de Células-Tronco , Tomografia Computadorizada por Raios X , Transplante AutólogoRESUMO
OBJECTIVE: To describe the clinical and radiologic features of cytomegalovirus (CMV) enterocolitis in apparently immunocompetent hosts. MATERIALS AND METHODS: Our institutional review board approved this retrospective study, and informed consent was waived. Twelve apparently immunocompetent patients (7 women and 5 men; mean age, 58 years) with pathologically proven CMV enterocolitis were included. Computed tomographic (CT) scans were retrospectively reviewed to determine the extent and the location of mural thickening, maximal mural thickness, enhancement pattern, that is, single-halo, double-halo, and homogeneous patterns, and ascites. RESULTS: Eight patients had comorbidities potentially affecting the host immune status, whereas 4 patients were apparently healthy before presentation. On CT, all patients showed mural thickening (range, 4-11 mm) involving the colon (n = 8), the small bowel (n = 1), or both (n = 3). Segmental involvement was most common (n = 9 for colon and n = 2 for small bowel), whereas focal involvement of the rectum (n = 1) and diffuse involvement of the entire ileum (n = 1) or the entire small bowel and colon (n = 1) were also noted. Colonic lesions showed variable enhancement patterns, including the single-halo (n = 6), homogeneous (n = 3), and double-halo patterns (n = 2), whereas all small-bowel lesions in 4 patients exhibited a single-ring pattern. Ascites was present in 7 patients. Complications requiring surgery occurred in 3 patients and included refractory bleeding (n = 2) and bowel perforation (n = 1). CONCLUSIONS: Cytomegalovirus enterocolitis in immunocompetent hosts typically develops in elderly subjects with comorbidities, although it may also affect relatively young and healthy subjects. On CT, it is characterized by mild mural thickening of the small bowel and the colon and frequently shows segmental involvement and a single-halo enhancement pattern.
Assuntos
Infecções por Citomegalovirus/diagnóstico por imagem , Enterocolite/diagnóstico por imagem , Enterocolite/virologia , Adulto , Idoso , Colonoscopia , Comorbidade , Meios de Contraste , Infecções por Citomegalovirus/imunologia , Infecções por Citomegalovirus/patologia , Infecções por Citomegalovirus/terapia , Enterocolite/imunologia , Enterocolite/terapia , Feminino , Humanos , Iohexol/análogos & derivados , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios XRESUMO
We report three cases of eosinophilic cystitis. Contrast-enhanced computed tomography (CT) revealed characteristic bladder wall thickening exceeding 10 mm, with preservation of the mucosal lining and intense, progressive contrast enhancement on sequential arterial and delayed scans. Eosinophilic cystitis might have been associated with eosinophilic infiltration in other organs, such as the gastrointestinal tracts and liver.
Assuntos
Cistite/diagnóstico por imagem , Enterocolite/diagnóstico por imagem , Eosinofilia/diagnóstico por imagem , Bexiga Urinária/diagnóstico por imagem , Adulto , Idoso de 80 Anos ou mais , Meios de Contraste , Cistite/complicações , Enterocolite/complicações , Eosinofilia/complicações , Humanos , Masculino , Tomografia Computadorizada por Raios X/métodosRESUMO
Duodenal diverticula generally occur in 2.5% of upper gastrointestinal examinations and are usually asymptomatic, but can cause hemorrhage on rare occasions. The frequency of gastrointestinal hemorrhage in patients with MDS or hematologic neoplasm caused by duodenal diverticulum is not known. Therefore, the correct diagnosis of intestinal hemorrhage is important, as severe enterocolitis may cause a patient with MDS to bleed from the diverticulum.