Inflammatory Disease of the Small Bowel
Inflammatory diseases of the small bowel can be classified into Crohn’s disease and inflammatory diseases other than Crohn’s disease. In a narrow sense, inflammatory disease of the bowel is considered to refer to the idiopathic inflammatory bowel disease
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Ijin Joo and Ah Young Kim
Contents 11.1 Imaging Techniques ........................................................................................................................
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11.2 Crohn’s Disease ...............................................................................................................................
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11.3 Eosinophilic Enteritis ......................................................................................................................
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11.4 Graft-Versus-Host Disease (GVHD) ..............................................................................................
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11.5 Illustrations: Inflammatory Disease of the Small Bowel .............................................................
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References ...................................................................................................................................................
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I. Joo Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea e-mail: [email protected] A.Y. Kim (*) Department of Radiology, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea e-mail: [email protected] B.I. Choi (ed.), Radiology Illustrated: Gastrointestinal Tract, Radiology Illustrated, DOI 10.1007/978-3-642-55412-4_11, © Springer-Verlag Berlin Heidelberg 2015
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I. Joo and A.Y. Kim
Introduction
Inflammatory diseases of the small bowel can be classified into Crohn’s disease and inflammatory diseases other than Crohn’s disease. In a narrow sense, inflammatory disease of the bowel is considered to refer to the idiopathic inflammatory bowel disease (IBD) which has two major phenotypes: Crohn’s disease and ulcerative colitis. While Crohn’s disease can affect any part of the gastrointestinal tract, ulcerative colitis is typically restricted to the colon (see Chap. 17). Therefore, Crohn’s disease is the major IBD of the small bowel. However, there are other inflammatory diseases involving the small bowel such as eosinophilic enteritis and graft-versus-host disease (GVHD). In this chapter, we will review the clinical features, pathophysiology, and characteristic imaging findings of the various kinds of inflammatory disease of the small bowel. In addition, we also briefly review the advantages and limitations of the imaging techniques which have been used for the evaluation of inflammatory disease of the small bowel.
11.1
Imaging Techniques
11.1.1 Small Bowel Follow-Through or Barium Enteroclysis Small bowel follow-through is a traditional method for the evaluation of suspected small bowel diseases which is a singlecontrast examination using a large volume of low-density barium. This technique has several important limitations. Due to the long transit time for the small bowel, some parts of small bowel loops may be often incompletely distended at the time of examination, and the full examination is time-consuming. Barium enteroclysis is also a traditional technique used in the diagnosis of small bowel disease. After the fluoroscopic placement of a
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