Small bowel enteroclysis with magnetic resonance imaging and computed tomography in patients with failed and uncertain passage of a patency capsule

<p>Abstract</p> <p>Background</p> <p>Video capsule enteroscopy (VCE) has revolutionized small bowel imaging, enabling visual examination of the mucosa of the entire small bowel, while MR enteroclysis (MRE) and CT enteroclysis (CTE) have largely replaced conventional barium enteroclysis. A new indication for MRE and CTE is the clinical suspicion of small bowel strictures, as indicated by delayed or non-delivery of a test capsule given before a VCE examination, to exclude stenosis. The aim of this study was to determine the clinical value of subsequent MRE and CTE in patients in whom a test capsule did not present itself in due time.</p> <p>Methods</p> <p>Seventy-five consecutive patients were identified with a delayed or unnoticed delivery of the test capsule. Seventy patients consented to participate and underwent MRE (44) or CTE (26). The medical records and imaging studies were retrospectively reviewed and symptoms, laboratory results and imaging findings recorded.</p> <p>Results</p> <p>Lesions compatible with Crohns disease were shown by MRE in 5 patients, by CTE in one and by VCE in four, one of whom had lesions on MRE. In patients without alarm symptoms and findings (weight loss, haematochezia, anaemia, nocturnal diarrheoa, ileus, fistula, abscess and abnormal blood tests) imaging studies did not unveil any such lesion. VCE's were performed in only 20 patients, mainly younger than 50 years of age, although no stenotic lesion was shown by MRE and CTE. In the remaining 50 patients no VCE or other endoscopic intervention was performed indicating that the referring physician was content with the diagnostic information from MRE or CTE.</p> <p>Conclusion</p> <p>The diagnostic value of MRE and CTE is sufficient for clinical management of most patients with suspected small bowel disease, and thus VCE may be omitted or at least postponed for later usage.</p

Enterobiasis vermicularis

Enterobius vermicularis (pinworm) infestation is quite common, especially in children and their caregivers. Often infection is symptomless, but more often there is perianal itching due to the adult females, which lay the eggs in the perianal region. Reinfection and person-to-person transmission is common. During colonoscopy, the adult female worms can be seen in the cecum, ascending colon, or distal ileum as white worms of 8-13 mm in length. This article is part of an expert video encyclopedia

Nonsteroidal anti-inflammatory drug associated colopathy

The potential harmful effect of nonsteroidal anti-inflammatory drugs (NSAIDs) on the stomach and duodenum is well known. NSAID-related damage to the colon is less frequently observed, but could result in inflammation, ulcers, and stricture formation. With the increasing use of NSAIDs, recognition of this phenomenon is important, because it can be confused with inflammatory bowel disease. This article is part of an expert video encyclopedia