Saturday, 19 December 2015

xrayoftheweek 50: a classic barium appearance

The #xrayoftheweek is this image from a barium study - this is a barium follow through to assess the small bowel. What can you see?

There are multiple features here of Crohn's disease of the proximal small bowel:
  • separation of loops indicating fat proliferation in mesentery
  • ulcer formation indicated by linear streaks filled with barium perpendicular to the lumen of the bowel
  • cobblestoning - thickened islands of mucosa separated by ulcers
  • areas of narrowing or stricture formation
This image is from a CT enterogram from the same person, showing the features on a cross-sectional study:

The additional findings seen on the CT are:
  • mesenteric lymphadenopathy
  • the comb sign - distended vasa recta secondary to bowel inflammation
You can read my post on how I use advanced MRI techniques to assess the small bowel in a previous #xrayoftheweek post.

#FOAMed #FOAMrad