Comparison of MR enteroclysis with colonoscopy in Crohn's disease--first locust bean gum study from Turkey.

BACKGROUND/AIM: The aim of this study was to compare magnetic resonance enteroclysis (MRE) findings with those of colonoscopy, using locust bean gum (LBG) as an oral contrast agent in the diagnosis and follow-up of patients with Crohn's disease. MATERIALS AND METHODS: Nine patients with histologically proven Crohn 's disease were enrolled in this study; MRE was performed within a week of colonoscopy. All patients were examined using a 1.5 T MR Scanner after per os administration of 850 mL of a combination of LBG and mannitol. After intravenous administration of 50 mg Eritromisin and 40 mg Scopolamine, images were obtained using a T2-weighted, balanced GRE, fat-suppressed T1-weighted sequence, before and after intravenous gadolinium administration. Bowel wall thickness and enhancement of inflamatory bowel wall were measured. RESULTS: The oral ingestion of LBG was well tolerated and allowed optimal small and large bowel distention in all patients. MR findings correlated with the colonoscopy results. Additional inflammatory lesions of the colon and mesenteric inflamatory changes such as lymphadenopathy, conglomerate tumor, and fistulas were demonstrated. Contrast enhancement of the affected bowel wall was markedly increased and positive correlation was obtained between bowel wall enhancement and bowel wall thickness. CONCLUSION: Gadolinium-enhanced MRE with oral locust bean gum is very efficient in the detection and follow-up of the intestinal and extraintestinal findings of Crohn's disease.

Colocalization of lipedematous scalp and nevus lipomatosus superficialis: a case report.

Lipedematous scalp (LS) is a rare condition of unknown etiology characterized by a thick, boggy scalp that occurs mostly in adult black females. The main pathologic finding consists of increased thickness of scalp resulting from thickening of the subcutaneous fat layer. Nevus lipomatosus superficialis (NLS) is an uncommon hamartomatous skin tumor characterized by soft, yellowish papules, or cerebriform plaques, usually localized on the buttock or thigh. Here, we report a 46-year-old woman who has NLS localized on the occipital area, accompanied by LS just beneath and peripheral area of this plaque. The diagnoses of NLS and LS were established by histopathological examination. In addition, the increase in subcutaneous fat layer was demonstrated using magnetic resonance imaging. The presented patient is the first case showing colocalization of NLS and LS.

Lipedematous scalp and lipedematous alopecia: report of three cases in white adults.

Lipedematous scalp (LS) and lipedematous alopecia (LA) are rare conditions of unknown etiology characterized by a thick and boggy scalp due to increase in the subcutaneous fat layer. Besides the changes in the texture of skin, varying degrees of hair loss are seen in patients with LA. In this report, we present two cases with LA and one case with LS in white adults. On examination, a boggy and soft swelling of the scalp was detected in all patients. In addition, the patients with LA had alopecic areas over the boggy scalp. Histopathologic examinations of skin biopsy specimens and magnetic resonance imaging of the scalp showed increased thickness of subcutaneous fat tissue in all patients. The exact etiopathogenesis of LA and LS remain unknown. These conditions may be either reactive or compansatory responses versus yet undetected stimuli, or represent a genetic tendency. Both of the these entities have been initially reported mostly in adult black females, however, we believe that LA and LS may well occur in white subjects and may be more widespread and frequently observed than previously supposed.