Radiological modalities versus histopathological finding in chronic small bowel diseases

ABSTRACT

The small intestine is one of the most difficult areas to study radiographically in the gastrointestinal tract, yet satisfactory investigations are needed to give the maximum definition of every inch of the intestine. Barium radiology remains the method of choice for diagnosis and evaluation of many small intestinal disorders. The other radiological modalities are helpful in diagnosis of chronic small bowel disorder and also detecting the associated pathology and the complications in the different organs. Aim of the work To evaluate the accuracy of the different radiological modalities in diagnosis of different chronic small bowel diseases. This study was conducted on 50 patients referred from the inpatients departments and outpatients' clinic of medicine and surgery to the radiology department of Bab El Sharia University hospital. They were 30 males and 20 females, their age ranged between 22 and 50 years. The predominant clinical presentations were diarrhea [40 cases], loss of body weight [34 cases], abdominal colic [42 cases], distension [18 cases], fever [6 cases] and bleeding per rectum [1 case]. The cases were submitted to the following Full clinical examination, Basic laboratory investigations and radiological studies. 38 patients of our conducted study were pathologically proven [76%]. Two cases [4%] were suspected to have small intestinal loops infiltration by an invasive ovarian carcinoma using another modality, while barium study decline this [our results was confirmed operatively]. On the other hand, there were four cases [8%] of post radiotherapy enteric changes having no definite criteria by barium study, and was diagnosed by previous clinical data of receiving radio-therapeutic treatment. Our study was non specific in two cases [4%]. Our study was negative in one patient suffering from obscure rectal bleeding proved by angiography to have a ceacal vascular malformation. Then we classified our population for more detailed analysis according to the type of abnormality into Post therapeutic complications [6 case], inflammatory diseases [18 cases], neoplastic disorders [6 cases], obstructive disorders [4 cases] and others [6 cases]. Barium study is a highly sensitive imaging tool for detecting small bowel disorder. However other radiological modalities with correlation with the histopathological finding are helpful in the diagnosis and detection of complications of different chronic small bowel diseases