Diaphragm disease of the small bowel: A retrospective review of CT findings

Kristina T. Flicek, Amy K. Hara, Giovanni De Petris, Shabana F Pasha, Anitha D. Yadav, C. Daniel Johnson

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE. The purpose of this article is to report the CT findings of pathologically proven diaphragm disease in the small bowel. MATERIALS AND METHODS. A retrospective review identified 12 patients with pathologically proven small-bowel diaphragm disease who underwent CT within 6 months of surgical resection. Two radiologists, who were unblinded to pathologic and clinical findings, evaluated CT examinations for imaging findings of disease extent, appearance, and location. Clinical history and postoperative follow-up were also performed. RESULTS. The most common presenting symptoms were abdominal pain (7/12 [58%]) and anemia (5/12 [42%]). Long-term use of nonsteroidal antiinflammatory drugs was documented in 58% (7/12) of patients. The most common location of small-bowel diaphragms was the ileum (8/12 [67%]). The CT findings were abnormal in 92% (11/12) of patients. The most common CT findings were small-bowel strictures (11/12 [92%]) and focal (median length, 1 cm) bowel wall thickening (8/12 [67%]). Other less common CT findings included mucosal hyperenhancement (6/12 [50%]), small-bowel dilatation (5/12 [42%]), and video capsule retention (6/9 [67%]). Postoperative follow-up in 11 patients found recurrent symptoms in four patients. CONCLUSION. Small-bowel diaphragm disease should be considered in patients with a history of long-term use of nonsteroidal antiinflammatory drugs, chronic abdominal pain, and anemia who present with CT findings of short, symmetric ileal strictures and focal bowel wall thickening.

Original languageEnglish (US)
JournalAmerican Journal of Roentgenology
Volume202
Issue number2
DOIs
StatePublished - Feb 2014

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Diaphragm
Abdominal Pain
Anemia
Pathologic Constriction
Anti-Inflammatory Agents
Ileum
Chronic Pain
Pharmaceutical Preparations
Capsules
Dilatation

Keywords

  • Diaphragm disease
  • Mucosal diaphragm disease
  • Nonsteroidal-induced enteropathy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Diaphragm disease of the small bowel : A retrospective review of CT findings. / Flicek, Kristina T.; Hara, Amy K.; De Petris, Giovanni; Pasha, Shabana F; Yadav, Anitha D.; Johnson, C. Daniel.

In: American Journal of Roentgenology, Vol. 202, No. 2, 02.2014.

Research output: Contribution to journalArticle

Flicek, Kristina T. ; Hara, Amy K. ; De Petris, Giovanni ; Pasha, Shabana F ; Yadav, Anitha D. ; Johnson, C. Daniel. / Diaphragm disease of the small bowel : A retrospective review of CT findings. In: American Journal of Roentgenology. 2014 ; Vol. 202, No. 2.
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abstract = "OBJECTIVE. The purpose of this article is to report the CT findings of pathologically proven diaphragm disease in the small bowel. MATERIALS AND METHODS. A retrospective review identified 12 patients with pathologically proven small-bowel diaphragm disease who underwent CT within 6 months of surgical resection. Two radiologists, who were unblinded to pathologic and clinical findings, evaluated CT examinations for imaging findings of disease extent, appearance, and location. Clinical history and postoperative follow-up were also performed. RESULTS. The most common presenting symptoms were abdominal pain (7/12 [58{\%}]) and anemia (5/12 [42{\%}]). Long-term use of nonsteroidal antiinflammatory drugs was documented in 58{\%} (7/12) of patients. The most common location of small-bowel diaphragms was the ileum (8/12 [67{\%}]). The CT findings were abnormal in 92{\%} (11/12) of patients. The most common CT findings were small-bowel strictures (11/12 [92{\%}]) and focal (median length, 1 cm) bowel wall thickening (8/12 [67{\%}]). Other less common CT findings included mucosal hyperenhancement (6/12 [50{\%}]), small-bowel dilatation (5/12 [42{\%}]), and video capsule retention (6/9 [67{\%}]). Postoperative follow-up in 11 patients found recurrent symptoms in four patients. CONCLUSION. Small-bowel diaphragm disease should be considered in patients with a history of long-term use of nonsteroidal antiinflammatory drugs, chronic abdominal pain, and anemia who present with CT findings of short, symmetric ileal strictures and focal bowel wall thickening.",
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N2 - OBJECTIVE. The purpose of this article is to report the CT findings of pathologically proven diaphragm disease in the small bowel. MATERIALS AND METHODS. A retrospective review identified 12 patients with pathologically proven small-bowel diaphragm disease who underwent CT within 6 months of surgical resection. Two radiologists, who were unblinded to pathologic and clinical findings, evaluated CT examinations for imaging findings of disease extent, appearance, and location. Clinical history and postoperative follow-up were also performed. RESULTS. The most common presenting symptoms were abdominal pain (7/12 [58%]) and anemia (5/12 [42%]). Long-term use of nonsteroidal antiinflammatory drugs was documented in 58% (7/12) of patients. The most common location of small-bowel diaphragms was the ileum (8/12 [67%]). The CT findings were abnormal in 92% (11/12) of patients. The most common CT findings were small-bowel strictures (11/12 [92%]) and focal (median length, 1 cm) bowel wall thickening (8/12 [67%]). Other less common CT findings included mucosal hyperenhancement (6/12 [50%]), small-bowel dilatation (5/12 [42%]), and video capsule retention (6/9 [67%]). Postoperative follow-up in 11 patients found recurrent symptoms in four patients. CONCLUSION. Small-bowel diaphragm disease should be considered in patients with a history of long-term use of nonsteroidal antiinflammatory drugs, chronic abdominal pain, and anemia who present with CT findings of short, symmetric ileal strictures and focal bowel wall thickening.

AB - OBJECTIVE. The purpose of this article is to report the CT findings of pathologically proven diaphragm disease in the small bowel. MATERIALS AND METHODS. A retrospective review identified 12 patients with pathologically proven small-bowel diaphragm disease who underwent CT within 6 months of surgical resection. Two radiologists, who were unblinded to pathologic and clinical findings, evaluated CT examinations for imaging findings of disease extent, appearance, and location. Clinical history and postoperative follow-up were also performed. RESULTS. The most common presenting symptoms were abdominal pain (7/12 [58%]) and anemia (5/12 [42%]). Long-term use of nonsteroidal antiinflammatory drugs was documented in 58% (7/12) of patients. The most common location of small-bowel diaphragms was the ileum (8/12 [67%]). The CT findings were abnormal in 92% (11/12) of patients. The most common CT findings were small-bowel strictures (11/12 [92%]) and focal (median length, 1 cm) bowel wall thickening (8/12 [67%]). Other less common CT findings included mucosal hyperenhancement (6/12 [50%]), small-bowel dilatation (5/12 [42%]), and video capsule retention (6/9 [67%]). Postoperative follow-up in 11 patients found recurrent symptoms in four patients. CONCLUSION. Small-bowel diaphragm disease should be considered in patients with a history of long-term use of nonsteroidal antiinflammatory drugs, chronic abdominal pain, and anemia who present with CT findings of short, symmetric ileal strictures and focal bowel wall thickening.

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