diagnostic role of magnetic resonance enterography as a complementary test to colonoscopy in active Crohn's disease

Background: According to recent studies comparing magnetic resonance enterography [MRE] with ileocolonoscopy for assessing inflammation of small bowel and colonic segments in adults with active Crohn's disease [CD], we aimed to compare the accuracy of these two diagnostic methods in Iranian population

Method: During 2013-2014 a follow-up study was done on 30 patients with active CD ina gastroenterology clinic affiliated to Tehran University of Medical Sciences. MRE and ileocolonoscopy were performed for all the patients. All statistical analyses were performed using SPSS [version 18] and P value<0.05 was considered as statistically significant

Results: Of the 30 patients with active CD, 11[36.7%] were men and 19 [63.3%] were women with mean age of 37.30 +/- 13.66 years [range: 19-67 years]. MRE had sensitivity and specificity of 50% and 90% with positive predictive value [PPV] and negative predictive value [NPV] of 71.43 and 78.26, respectively for localizing sigmoid lesions and ileum had sensitivity and specificity of 84.21 and 45.45 with PPV and NPV of 72.73 and 62.50, respectively

Conclusion: While moderate sensitivity and high specificity of MRE in localizing colonic lesions makes it an appropriate confirmatory test after colonoscopy, the reported high sensitivity and moderate specificity of MRE versus colonoscopy in detecting ileal lesions makes it a suitable screening test for ileal lesions. Finally we can conclude that MRE can be an important complementary test to colonoscopy in detecting active disease

Annular pancreas presenting with painless jaundice: a case report and review of literature

Annular pancreas [AP] is a rare congenital abnormality in which pancreatic tissue completely surround the duodenum. Presentation of AP in adulthood is very rare and obstructive jaundice is one of the uncommon manifestations of AP in adults. Herein; we reported a 47 years old woman who presented with icterus, mid common bile duct stricture and annular pancreas. She was diagnosed as pancreas cancer three months after surgery. Although AP presenting with jaundice is rare but is indicative of significant relationship with periampullary malignancies and requires a complete investigation of these cancers and close follow up