Type:
Educational Exhibit
Keywords:
Abdomen, Gastrointestinal tract, Emergency, CT, Contrast agent-intravenous, Dilatation, Inflammation, Ischaemia / Infarction
Authors:
J.-D. Chen; Taipei/TW
DOI:
10.1594/ecr2013/C-1824
Background
CT plays an important role in the evaluation of patients with acute abdomen in emergency department.
High-resolution imaging of gastrointestinal tract by helical CT or multidetector CT allows assessment of both mural abnormality and related extraluminal change.
Thickened bowel wall is often encountered by the radiologists in CT interpretation of acute abdomen.
Such an abnormal change of bowel wall may suggest gastrointestinal tract disorders,
but differential diagnosis is wide,
ranging from mild,
non-specific medical condition to life-threatening surgical condition.
Intriguing CT patterns of bowel wall thickening make the task of correct diagnosis more complicated.
The authors observed different CT features of bowel wall thickening related to variable gastrointestinal diseases,
including inflammation,
ischemia,
intramural hemorrhage,
neoplasm and bowel edema (intramural fluid retention caused by portal hypertension,
hypoalbuminemia or angioedema).
Correct Diagnosis is important because treatment varies.
The categorization of major differential diagnosis may be facilitated by analyzing the symmetry and degree of wall thickness,
wall attenuation,
distribution and length of extent,
contrast-enhancing pattern and perienteric change.