Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 69
Filter
1.
Comput Methods Programs Biomed ; 230: 107320, 2023 Mar.
Article in English | MEDLINE | ID: mdl-36608429

ABSTRACT

BACKGROUND AND OBJECTIVE: Celiac Disease (CD) is characterized by gluten intolerance in genetically predisposed individuals. High disease prevalence, absence of a cure, and low diagnosis rates make this disease a public health problem. The diagnosis of CD predominantly relies on recognizing characteristic mucosal alterations of the small intestine, such as villous atrophy, crypt hyperplasia, and intraepithelial lymphocytosis. However, these changes are not entirely specific to CD and overlap with Non-Celiac Duodenitis (NCD) due to various etiologies. We investigated whether Artificial Intelligence (AI) models could assist in distinguishing normal, CD, and NCD (and unaffected individuals) based on the characteristics of small intestinal lamina propria (LP). METHODS: Our method was developed using a dataset comprising high magnification biopsy images of the duodenal LP compartment of CD patients with different clinical stages of CD, those with NCD, and individuals lacking an intestinal inflammatory disorder (controls). A pre-processing step was used to standardize and enhance the acquired images. RESULTS: For the normal controls versus CD use case, a Support Vector Machine (SVM) achieved an Accuracy (ACC) of 98.53%. For a second use case, we investigated the ability of the classification algorithm to differentiate between normal controls and NCD. In this use case, the SVM algorithm with linear kernel outperformed all the tested classifiers by achieving 98.55% ACC. CONCLUSIONS: To the best of our knowledge, this is the first study that documents automated differentiation between normal, NCD, and CD biopsy images. These findings are a stepping stone toward automated biopsy image analysis that can significantly benefit patients and healthcare providers.


Subject(s)
Celiac Disease , Duodenitis , Noncommunicable Diseases , Humans , Celiac Disease/diagnosis , Duodenitis/diagnostic imaging , Duodenitis/pathology , Artificial Intelligence , Biopsy , Intestinal Mucosa/diagnostic imaging
2.
J Laparoendosc Adv Surg Tech A ; 31(6): 672-675, 2021 Jun.
Article in English | MEDLINE | ID: mdl-32882153

ABSTRACT

Aim: The routine use of esophagogastroduodenoscopy (EGD) during the preoperative evaluation of surgical weight loss candidates is controversial. The aim of this study is to evaluate the findings of preoperative EGD in patients who are scheduled for a primary laparoscopic sleeve gastrectomy (LSG). The probable effect of these findings on the medical and surgical strategy that was followed is assessed. Methods: Findings of EGD obtained from consecutive LSG candidates and all data were prospectively recorded and retrieved from the database. Results: A total of 819 patients underwent EGD successfully. Mean age and body mass index were 38 ± 11.3 and 43.17 ± 7.2 kg/m2, respectively. Fifty-eight percent were female. EGD of 263 (32.1%) patients was normal and 687 (84%) patients were asymptomatic. At least one abnormal finding was detected in 65% of the asymptomatic patients. Abnormal findings that did not change the surgical strategy were found in 550 patients (67.2%). Findings such as gastritis or duodenitis that changed the medical management before surgery were found in 309 patients (38.2%). Helicobacter pylori was positive in 218 (26.6%) patients but eradication treatment was not applied in the preoperative period. No pathology was detected that would create absolute contraindication or change the type of surgery in any patient. Only technical modifications were required in 13% due to hiatal hernia. The timing of the planned surgery has changed in only 6 patients (0.74%) (early stage neuroendocrine tumor, leiomyoma, severe ulcer). Conclusions: Routine EGD performed before LSG did not change the planned bariatric option in any patient, but led to 13% rate of technical modifications due to the presence of hiatal hernia. At least one abnormal finding was detected in 65% of asymptomatic patients. Due to endoscopic findings, the rate of patients who started medical acid-suppression treatment in the preoperative period was 38%.


Subject(s)
Endoscopy, Digestive System , Gastrectomy/methods , Helicobacter Infections/diagnostic imaging , Helicobacter pylori , Hernia, Hiatal/diagnostic imaging , Obesity, Morbid/surgery , Adult , Body Mass Index , Clinical Decision-Making , Duodenitis/diagnostic imaging , Female , Gastritis/diagnostic imaging , Humans , Laparoscopy , Male , Middle Aged , Preoperative Care , Preoperative Period , Retrospective Studies
3.
Ir Med J ; 113(6): 102, 2020 06 11.
Article in English | MEDLINE | ID: mdl-32816437

ABSTRACT

Presentation A male patient with no significant past medical history presented to emergency department with progressive in severity abdominal pain, associated with mild nausea and diarrhea. No other significant symptoms were reported. Diagnosis On investigation with CT, duodenojejunitis was diagnosed as the cause of abdominal pain. Lung basal changes were also visualized and subsequently proven to be secondary to Covid-19 infection. Treatment After few days of hospitalization and supportive treatment, the patient improved clinically and was discharged. Conclusion Covid-19 infection typically presents with respiratory symptoms associated with fever and myalgia. Anorexia, diarrhea and nausea have been reported. Severe abdominal pain is rare, particularly as the initial presenting compliant. It is important to be aware of the varied clinical presentations that may occur in Covid-19, including isolated gastrointestinal symptoms. This will allow to increase the timely detectability of infected patients and more effective contact control measures.


Subject(s)
Abdomen, Acute/virology , Coronavirus Infections/diagnosis , Duodenitis/virology , Enteritis/virology , Jejunal Diseases/virology , Pneumonia, Viral/diagnosis , Abdomen, Acute/diagnostic imaging , Betacoronavirus , COVID-19 , Coronavirus Infections/diagnostic imaging , Duodenitis/diagnostic imaging , Emergency Service, Hospital , Enteritis/diagnostic imaging , Humans , Jejunal Diseases/diagnostic imaging , Lung/diagnostic imaging , Male , Middle Aged , Pandemics , Pneumonia, Viral/diagnostic imaging , SARS-CoV-2 , Tomography, X-Ray Computed
4.
Pediatr Emerg Care ; 35(8): e152-e153, 2019 Aug.
Article in English | MEDLINE | ID: mdl-28617713

ABSTRACT

The radiographic finding of gastric emphysema with portal venous gas is classically an ominous finding, associated with a high rate of mortality. Although classically the case, this imaging finding must be quickly correlated with the overall clinical picture, allowing for the essential differentiation between the highly lethal emphysematous gastritis and the much more benign gastric emphysema, each of which has drastically different management strategies. We report a case of gastric emphysema with portal venous gas likely attributable to a gastric outlet obstruction and gastric mucosal defect in a 17-year-old girl with a chief complaint of syncope that was diagnosed in the emergency department and treated conservatively.


Subject(s)
Emphysema/complications , Stomach Diseases/diagnostic imaging , Syncope/etiology , Adolescent , Conservative Treatment , Constriction, Pathologic , Duodenitis/diagnostic imaging , Duodenitis/pathology , Endoscopy, Digestive System/methods , Female , Humans , Pylorus/pathology , Stomach Diseases/pathology , Stomach Ulcer/diagnostic imaging , Stomach Ulcer/pathology , Syncope/diagnosis , Tomography, X-Ray Computed/methods , Vomiting/diagnosis , Vomiting/etiology
5.
Rev Gastroenterol Peru ; 38(1): 40-43, 2018.
Article in English | MEDLINE | ID: mdl-29791420

ABSTRACT

OBJECTIVE: To present and discuss the endoscopic and histological results, as well as the incidence of Helicobacter pylori and other diseases, indications and characteristics of upper digestive endoscopies performed in children. MATERIAL AND METHODS: Twenty-five endoscopies were performed in children aged six months to 11 years (mean 7.69 years), from February 2013 to January 2016. In 200 patients, endoscopies were diagnostic and serial biopsies were performed (esophagus, stomach and duodenum), in 120 of them. RESULTS: The indication of endoscopy was diagnosed in 88.89% of the patients, and in 26 patients, a therapeutic procedure was performed. The most frequent endoscopic findings were esophagitis in 49 patients, gastritis in 84 and duodenitis in 16 patients. Four duodenal ulcers were diagnosed. In the therapeutic endoscopies, six gastrostomies were performed, 14 foreign body withdrawals, five nasoenteral tube passages and esophageal dilatation. The H. pylori survey was performed by anatomopathological method and was positive in 26 (13%) of the 200 patients in whom it was searched. CONCLUSION: pediatric endoscopy is an important niche of the digestive endoscopy, where it is important to emphasize the relevance of the institutional structure that performs these procedures, in order to conduct them safely, being able to treat possible and feasible complications.


Subject(s)
Duodenal Ulcer/diagnostic imaging , Duodenitis/diagnostic imaging , Endoscopy, Gastrointestinal , Esophagitis/diagnostic imaging , Gastritis/diagnostic imaging , Helicobacter Infections/diagnostic imaging , Helicobacter pylori , Brazil/epidemiology , Child , Child, Preschool , Duodenal Ulcer/epidemiology , Duodenal Ulcer/therapy , Duodenitis/epidemiology , Duodenitis/therapy , Esophagitis/epidemiology , Esophagitis/therapy , Gastritis/epidemiology , Gastritis/therapy , Helicobacter Infections/epidemiology , Helicobacter Infections/therapy , Humans , Incidence , Infant , Retrospective Studies , Treatment Outcome
6.
Rev. gastroenterol. Perú ; 38(1): 40-43, jan.-mar. 2018. ilus, tab
Article in English | LILACS | ID: biblio-1014056

ABSTRACT

Objective: To present and discuss the endoscopic and histological results, as well as the incidence of Helicobacter pylori and other diseases, indications and characteristics of upper digestive endoscopies performed in children. Material and methods: Twenty-five endoscopies were performed in children aged six months to 11 years (mean 7.69 years), from February 2013 to January 2016. In 200 patients, endoscopies were diagnostic and serial biopsies were performed (esophagus, stomach and duodenum), in 120 of them. Results: The indication of endoscopy was diagnosed in 88.89% of the patients, and in 26 patients, a therapeutic procedure was performed. The most frequent endoscopic findings were esophagitis in 49 patients, gastritis in 84 and duodenitis in 16 patients. Four duodenal ulcers were diagnosed. In the therapeutic endoscopies, six gastrostomies were performed, 14 foreign body withdrawals, five nasoenteral tube passages and esophageal dilatation. The H. pylori survey was performed by anatomopathological method and was positive in 26 (13%) of the 200 patients in whom it was searched. Conclusion: pediatric endoscopy is an important niche of the digestive endoscopy, where it is important to emphasize the relevance of the institutional structure that performs these procedures, in order to conduct them safely, being able to treat possible and feasible complications


Objetivo: Presentar y discutir los hallazgos endoscópicos e histológicos, así como la incidencia de Helicobacter pylori y otras enfermedades, indicaciones y características de endoscopia digestiva alta realizada en niños. Material y métodos: Fueron realizadas 225 endoscopias en niños de seis meses a 11 años (media de 7,69 años) a partir de febrero de 2013 hasta enero de 2016. En 200 pacientes, en las endoscopias diagnósticas se llevan a cabo biopsias seriadas (esófago, estómago y duodeno) en 120 de ellos. Resultados: La indicación de endoscopia fue diagnóstica en el 88,89% de los pacientes y en 26 pacientes se realizaron un procedimiento terapéutico. Los hallazgos endoscópicos más frecuentes fueron esofagitis en 49 pacientes, gastritis y duodenitis 84 y en 16 pacientes se diagnosticaron cuatro úlceras duodenales. En endoscopias terapéuticas fueron realizadas seis gastrostomías, catorce extracciones de cuerpos extraños, cinco pasajes de sonda nasogástrica y una dilatación esofágica. El estudio de H. pylori se realizó por el método histopatológico y fué positivo en 26 (13%) de 200 pacientes en los que se han buscado. Conclusión: La endoscopía pediátrica es un nicho importante de la endoscopía digestiva donde es importante enfatizar la relevancia de la estructura institucional que realiza estos procedimientos para conducirlos con seguridad y ser capaces de tratar las complicaciones posibles


Subject(s)
Child , Child, Preschool , Humans , Infant , Endoscopy, Gastrointestinal , Helicobacter pylori , Helicobacter Infections/diagnostic imaging , Duodenal Ulcer/diagnostic imaging , Duodenitis/diagnostic imaging , Esophagitis/diagnostic imaging , Gastritis/diagnostic imaging , Brazil/epidemiology , Incidence , Retrospective Studies , Helicobacter Infections/therapy , Helicobacter Infections/epidemiology , Treatment Outcome , Duodenal Ulcer/therapy , Duodenal Ulcer/epidemiology , Duodenitis/therapy , Duodenitis/epidemiology , Esophagitis/therapy , Esophagitis/epidemiology , Gastritis/therapy , Gastritis/epidemiology
7.
Radiology ; 285(3): 1045-1051, 2017 12.
Article in English | MEDLINE | ID: mdl-29155635

ABSTRACT

History A 59-year-old man presented to the gastroenterology outpatient department with acute abdominal pain centered in the epigastrium. He had experienced similar episodes of abdominal pain in the past that had been treated with surgery. He reported multiple failed attempts at upper gastrointestinal endoscopy. Laboratory tests were performed at the time of admission and revealed a serum glutamic-oxaloacetic transaminase level of 9 U/L [0.15 µkat/L] (normal range, 5-40 U/L [0.08-0.67 µkat/L]), a serum glutamic-pyruvic transaminase level of 34 U/L [0.57 µkat/L] (normal range, 5-45 U/L [0.08-0.75 µkat/L]), a serum γ-glutamyltransferase level of 210 U/L (3.50 µkat/L) (normal range, 10-50 U/L [0.17-0.83 µkat/L]), a serum alkaline phosphatase level of 157 U/L (2.62 µkat/L) (normal range, 30-120 U/L [0.50-2.0 µkat/L]), a serum amylase level of 210 U/L (3.50 µkat/L) (normal range, 30-100 U/L [0.50-1.66 µkat/L]), a serum lipase level of 391 U/L (6.52 µkat/L) (normal range, 13-60 U/L [0.21-1.0 µkat/L]), an α-fetoprotein level of 3.81 ng/ mL (normal range, 0-9 ng/mL), a total protein level of 4.6 g/dL (normal range, 6.0-8.5 g/dL), and an albumin level of 2.6 g/dL (normal range, 3.5-5.2 g/dL). The rest of the laboratory data were unremarkable. The patient underwent erect abdominal radiography, contrast material-enhanced multidetector row computed tomography (CT) of the abdomen with 100 mL of iohexol (300 mg iodine per milliliter, Omnipaque; GE Healthcare, Shanghai, China) followed by combined positron emission tomography (PET) and CT (hereafter, PET/CT) with 6.9 mCi of fluorodeoxyglucose (FDG) and magnetic resonance (MR) imaging of the upper abdomen.


Subject(s)
Cysts/diagnostic imaging , Cysts/surgery , Duodenitis/diagnostic imaging , Duodenitis/surgery , Pancreatitis, Chronic/diagnostic imaging , Pancreatitis, Chronic/surgery , Diagnosis, Differential , Fatal Outcome , Humans , Male , Middle Aged , Pancreaticoduodenectomy/methods , Treatment Outcome
8.
BMJ Case Rep ; 20172017 Jun 13.
Article in English | MEDLINE | ID: mdl-28611166

ABSTRACT

Cytomegalovirus (CMV) infection is a well-recognised complication of immunodeficiency, although the burden of CMV disease in immunocompetent adults is still unknown. We present the case of a 54-year-old male patient admitted due to severe diarrhoea, epigastric pain and fever. Initial diagnostic workup revealed pericardial and pleural effusion, enlarged abdominal lymph nodes and mild elevation of liver enzymes. CMV serology was IgM positive, and upper endoscopy revealed proximal enteritis. Histology and immunohistochemistry of duodenal samples confirmed CMV disease. An extensive investigation of possible immunodeficiency was conducted with positron emission tomography (PET) scan revealing an abnormal hypermetabolic pulmonary nodule. The patient underwent a right superior lobectomy which, on analysis, confirmed an atypical bronchopulmonary carcinoid tumour. We report this case to reinforce the importance of considering CMV infection as a differential diagnosis in apparent immunocompetent patients and to emphasise the importance of looking for any condition that may cause any degree of immune dysfunction.


Subject(s)
Carcinoid Tumor/diagnosis , Cytomegalovirus Infections/diagnosis , Duodenitis/diagnosis , Lung Neoplasms/diagnosis , Antiviral Agents/therapeutic use , Carcinoid Tumor/complications , Carcinoid Tumor/diagnostic imaging , Carcinoid Tumor/surgery , Cytomegalovirus Infections/complications , Cytomegalovirus Infections/diagnostic imaging , Cytomegalovirus Infections/drug therapy , Diagnosis, Differential , Duodenitis/complications , Duodenitis/diagnostic imaging , Duodenitis/drug therapy , Duodenoscopy , Humans , Immunocompetence , Lung Neoplasms/complications , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/surgery , Male , Middle Aged , Positron-Emission Tomography
9.
Acta Gastroenterol Belg ; 80(1): 91, 2017.
Article in English | MEDLINE | ID: mdl-29364111

ABSTRACT

Duodenal nodularity is an uncommon endoscopic finding charac-trized by numerous visible mucosal nodules in the duodenum. It is important to consider giardiasis in patients with symptoms include abdominal pain, nausea, anorexia, diarrhea, vomiting, weight loss and abdominal distension. It is also important to remind giardiasis in patients with duodenal nodularity.


Subject(s)
Duodenitis/diagnostic imaging , Duodenitis/parasitology , Giardiasis/complications , Adult , Duodenitis/pathology , Dyspepsia/parasitology , Endoscopy, Gastrointestinal , Female , Giardiasis/diagnostic imaging , Giardiasis/pathology , Humans , Weight Loss
13.
Khirurgiia (Mosk) ; (8): 16-23, 2010.
Article in Russian | MEDLINE | ID: mdl-20823815

ABSTRACT

Two patients with cystic dystrophy of duodenum and chronic inflammation of duodenally ectopic pancreatic tissue were successfully operated on. Both cases clinically demonstrated abdominal pain and duodenal obstruction. Absence of substantial tissue changes in "main" pancreas allowed execution of pancreas-preserving operation. Thus, subtotal duodenectomy was performed in the first patient. The second patient had resection of vertical branch of the duodenum with intestinal fragment replacement. Extensive periorganic fibrosis in both cases substantially complicated verification of anatomic structures and dissection.


Subject(s)
Choristoma/surgery , Common Bile Duct/surgery , Cysts/surgery , Duodenitis/surgery , Pancreatic Ducts , Pancreaticoduodenectomy/methods , Adult , Cysts/diagnostic imaging , Duodenitis/diagnostic imaging , Humans , Magnetic Resonance Imaging , Male , Tomography, X-Ray Computed
14.
Gastroenterol Hepatol ; 32(1): 22-8, 2009 Jan.
Article in Spanish | MEDLINE | ID: mdl-19174095

ABSTRACT

We analyzed the clinical, radiographic and histologic characteristics, as well as the difficulties that arose in the differential diagnosis between groove pancreatitis (a benign entity consisting of a segmental form of chronic pancreatitis occurring as a sheet-like scar in the area of pancreatoduodenal groove) and adenocarcinoma of the pancreas. To this end, four cases with abnormalities in the groove area were retrospectively reviewed, three with groove pancreatitis, and one with adenocarcinoma of the pancreas. The important role of imaging techniques is highlighted, with emphasis on magnetic resonance imaging of the pancreas and magnetic resonance cholangiography, which reveal certain differentiating characteristics between these two entities. However, distinguishing between these entities is often difficult, and sometimes impossible. Consequently, cyto-histological study is always required.


Subject(s)
Adenocarcinoma/diagnosis , Duodenitis/diagnosis , Pancreatic Neoplasms/diagnosis , Pancreatitis/diagnosis , Adenocarcinoma/diagnostic imaging , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Adult , Aged , Biopsy, Fine-Needle , Cholangiopancreatography, Endoscopic Retrograde , Cholangiopancreatography, Magnetic Resonance , Cholelithiasis/complications , Cholelithiasis/diagnosis , Chronic Disease , Diagnosis, Differential , Duodenitis/diagnostic imaging , Duodenitis/pathology , Duodenum/pathology , Fatal Outcome , Humans , Intestinal Mucosa/pathology , Magnetic Resonance Imaging , Male , Middle Aged , Pancreatic Neoplasms/diagnostic imaging , Pancreatic Neoplasms/pathology , Pancreatic Neoplasms/surgery , Pancreaticoduodenectomy , Pancreatitis/classification , Pancreatitis/diagnostic imaging , Pancreatitis/pathology , Pancreatitis, Alcoholic/complications , Retrospective Studies
16.
Australas Radiol ; 48(4): 516-9, 2004 Dec.
Article in English | MEDLINE | ID: mdl-15601333

ABSTRACT

Peptic ulcer disease (PUD) can present with many complications including inflammation, ulceration and perforation. Improvements in CT have enabled better imaging of the gastroduodenal area. Three cases of complicated PUD detected on CT are presented with a brief review of the current literature.


Subject(s)
Duodenal Ulcer/diagnostic imaging , Duodenitis/diagnostic imaging , Peptic Ulcer Perforation/diagnostic imaging , Stomach Ulcer/diagnostic imaging , Tomography, X-Ray Computed , Adult , Aged , Diagnosis, Differential , Female , Humans , Male
18.
Crit Rev Comput Tomogr ; 45(5-6): 309-34, 2004.
Article in English | MEDLINE | ID: mdl-15747573

ABSTRACT

Computed Tomography (CT) is useful for evaluation of both benign and malignant pathology involving the duodenum. CT can detect and stage duodenal malignancies as well as detect inflammatory conditions such as duodenitis. Careful CT technique is necessary to optimize detection of abnormalities. This includes the use of oral contrast, preferably water, as well as i.v. contrast. 3D imaging can improve disease detection and help with surgical planning. This article reviews the current role of CT in duodenal imaging, describes appropriate CT protocols and illustrates a wide variety of duodenal pathology.


Subject(s)
Duodenal Neoplasms/diagnostic imaging , Duodenitis/diagnostic imaging , Duodenum/diagnostic imaging , Tomography, X-Ray Computed/methods , Abdominal Injuries/diagnostic imaging , Duodenum/abnormalities , Duodenum/injuries , Humans , Imaging, Three-Dimensional , Tomography, X-Ray Computed/instrumentation
19.
J Pediatr ; 143(1): 48-53, 2003 Jul.
Article in English | MEDLINE | ID: mdl-12915823

ABSTRACT

OBJECTIVE: To evaluate (99m)Tc-HMPAO leukocyte scintigraphy as an investigation for inflammatory bowel disease (IBD). STUDY DESIGN: Scintigraphy was performed in 95 children undergoing investigation for IBD in a tertiary Gastroenterology Department. Diagnosis was based on conventional investigations including small bowel barium contrast radiology (BCR), upper gastrointestinal endoscopy (UGIE), colonoscopy, and endoscopic biopsy (the "gold standards"). IBD was confirmed in 73 (57 Crohn's disease; 10 ulcerative colitis; 6 indeterminate colitis) and excluded in 22 (controls). Scintigraphy was (1) evaluated as a screening test, (2) compared with individual conventional tests, (3) assessed for each gut segment. RESULTS: Screening test: sensitivity 0.75 (95% CI, 0.63-0.85), specificity 0.82 (95% CI, 0.59-0.94), PPV 0.93, NPV 0.5. Comparison with BCR: sensitivity 0.87 (95% CI, 0.72-0.96), specificity 0.57 (95% CI, 0.39-0.73), PPV 0.69, NPV 0.2. Comparison with UGIE: specificity 0.9 (95% CI, 0.79-0.96), NPV 0.13 (sensitivity and PPV unavailable). Comparison with colonoscopy: sensitivity 0.57 (95% CI, 0.41-0.73), specificity 0.71 (95% CI, 0.54-0.85), PPV 0.71, NPV 0.42. Comparison with biopsies paralleled that with endoscopy. False negatives were especially common (NPV< or =0.2) in the proximal gut. CONCLUSIONS: (99m)Tc-HMPAO leukocyte scintigraphy should not be relied on as a screening test for IBD because false negative results are common. This method is especially unreliable at detecting disease in the proximal gut.


Subject(s)
Colitis, Ulcerative/diagnostic imaging , Crohn Disease/diagnostic imaging , Duodenitis/diagnostic imaging , Enteritis/diagnostic imaging , Gastritis/diagnostic imaging , Leukocytes/diagnostic imaging , Radiopharmaceuticals , Technetium Tc 99m Exametazime , Adolescent , Child , Child, Preschool , Colon/pathology , Colonoscopy/methods , Female , Humans , Intestinal Mucosa/pathology , Male , Predictive Value of Tests , Radionuclide Imaging
20.
Arch Dis Child ; 85(1): 43-6, 2001 Jul.
Article in English | MEDLINE | ID: mdl-11420197

ABSTRACT

OBJECTIVE: To investigate the use of (99m)Tc-HMPAO (hexamethyl propylene amine oxime) leucocyte scintigraphy as a non-invasive screening test for inflammatory bowel disease. PATIENTS: 10 children with suspected Crohn's disease, in whom routine investigation using barium contrast radiology, upper gastrointestinal endoscopy, colonoscopy, and mucosal biopsies had identified severe gastroduodenal and/or jejunal involvement. DESIGN: (99m)Tc-HMPAO leucocyte scintigraphic studies performed in each of these cases were assessed by a radiologist who was blinded to the disease distribution. RESULTS: In nine cases there was no scintigraphic evidence of inflammation in the proximal gastrointestinal tract. The 10th child had both gastroduodenal and jejunal involvement, but scintigraphy only revealed faint jejunal positivity. CONCLUSIONS: (99m)Tc-HMPAO leucocyte scintigraphy should not be depended upon as a screening test for Crohn's disease. False negative results are likely in cases with Crohn's disease confined to the proximal gastrointestinal tract.


Subject(s)
Crohn Disease/diagnostic imaging , Gastritis/diagnostic imaging , Radiopharmaceuticals , Technetium Tc 99m Exametazime , Barium Sulfate , Biopsy , Child , Contrast Media , Crohn Disease/pathology , Duodenitis/diagnostic imaging , Endoscopy, Gastrointestinal , Enteritis/diagnostic imaging , False Negative Reactions , Humans , Predictive Value of Tests , Radionuclide Imaging
SELECTION OF CITATIONS
SEARCH DETAIL
...