Small Bowel Ultrasound beyond Inflammatory Bowel Disease: An Updated Review of the Recent Literature Federica Cavalcoli, Alessandra Zilli, Mirella Fraquelli,

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Presentation transcript:

Small Bowel Ultrasound beyond Inflammatory Bowel Disease: An Updated Review of the Recent Literature Federica Cavalcoli, Alessandra Zilli, Mirella Fraquelli, Dario Conte, Sara Massironi Ultrasound in Medicine and Biology Volume 43, Issue 9, Pages 1741-1752 (September 2017) DOI: 10.1016/j.ultrasmedbio.2017.04.028 Copyright © 2017 World Federation for Ultrasound in Medicine & Biology Terms and Conditions

Fig. 1 Diverticulitis. Longitudinal scan of a tract of sigmoid colon revealing a thickened wall with a painful sacculation of 1.4 cm (white arrow) with air inclusions (air/feces in the diverticulum). Moreover, a hyper-echoic aspect of the mesentery surrounds this bowel loop (black arrows). Ultrasound in Medicine and Biology 2017 43, 1741-1752DOI: (10.1016/j.ultrasmedbio.2017.04.028) Copyright © 2017 World Federation for Ultrasound in Medicine & Biology Terms and Conditions

Fig. 2 Celiac disease. Typical features of celiac disease. The top figure reveals free abdominal fluid (black arrow) in the right lower quadrant and dilation (diameter = 2.7 cm) of a small bowel loop filled with corpusculated luminal content (white dotted line), whereas the bottom figure reveals the presence of reactive mesenteric lymph nodes (crosses, asterisks). Ultrasound in Medicine and Biology 2017 43, 1741-1752DOI: (10.1016/j.ultrasmedbio.2017.04.028) Copyright © 2017 World Federation for Ultrasound in Medicine & Biology Terms and Conditions

Fig. 3 Cystic fibrosis. Ultrasound of the right upper quadrant reveals the classic image of bowel intussusception, characterized by a “bull's eye” lesion representing layers of the intestine within the intestine. Few intestinal loops with normal parietal layers are also observed. Patients with cystic fibrosis may present with transient asymptomatic small bowel intussusception. Ultrasound in Medicine and Biology 2017 43, 1741-1752DOI: (10.1016/j.ultrasmedbio.2017.04.028) Copyright © 2017 World Federation for Ultrasound in Medicine & Biology Terms and Conditions

Fig. 4 Infection by Yersinia enterocolitica. In the upper ultrasound scan, the wall thickening of the terminal ileum and ascending colon has a “target-like” appearance, with initial loss of parietal stratification. The inner hypo-echoic layer (mucosa) and middle hyper-echoic layer (submucosa) are diffusely thickened and hypervascularized on color Doppler evaluation, whereas the muscular layer is normal. Moreover, in the lower scan, several mesenteric lymph nodes are moderately enlarged and arranged in a “rosary-like shape” along the mesentery; peri-ileal soft tissue is hyper-echoic because of edema and inflammation. This ultrasound pattern is typical of infectious colitis, such as that caused by Y. enterocolitica infection. Ultrasound in Medicine and Biology 2017 43, 1741-1752DOI: (10.1016/j.ultrasmedbio.2017.04.028) Copyright © 2017 World Federation for Ultrasound in Medicine & Biology Terms and Conditions