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[Intestinal B-mode sonography in patients with endemic sprue. Intestinal sonography in endemic sprue].

Abstract

AIM

The value of ultrasonography in the diagnosis, follow-up and for the detection of complications in patients with celiac sprue has not yet been sufficiently evaluated. A pronounced back and forth motility with echo-rich hump reflexes in a fluid-filled small bowel with a reduction of Kerckring's plicae circulares and with a loss of their density and uniformity was empirically defined as a diagnostic sign of celiac sprue. In the present study, the sonographic signs of celiac sprue were examined as an indicator of active sprue.

METHOD

50 patients with histologically proven celiac sprue were examined with real time ultrasonography (3.5-7 MHz). The detection or exclusion of the defined sonographic signs of celiac sprue with intensified motility and reduction of Kerckring's plicae circulares with a loss of their density and uniformity were evaluated by two independent examiners and documented without knowledge of the clinical findings. The clinical activity (active vs. remission) was assessed according to clinical criteria (diarrhea, steatorrhea, weight loss). 38 healthy subjects and 50 patients with Crohn's disease served as controls.

RESULTS

In all 138 patients and controls adequate visualization of the bowel was achieved. In 16/50 (32%) patients with active celiac sprue changes of motility and reduction of Kerckring's plicae circulares with a loss of their density and uniformity were detected, whereas all 34/50 (68%) of patients with celiac sprue in remission did not have this pattern. In none of the controls with Crohn's disease or in the healthy subjects comparative sonographic signs of active celiac sprue were observed. In four patients with active celiac sprue a circumscript echopoor tumor of the small bowel wall could be sonographically detected, which turned out to be T-cell lymphoma in three and a carcinoma of the small intestine in one patient. An increased number of and/or enlarged mesenteric lymph nodes were found in patients with active celiac sprue.

CONCLUSION

Changes of motility and reduction of Kerckring's plicae circulares with loss of density and uniformity at ultrasonography are a reliable indicator of active celiac sprue.

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  • Authors+Show Affiliations

    ,

    Medizinische Klinik II, Johann Wolfgang Goethe-Universitätsklinikum, Frankfurt.

    , , , ,

    Source

    MeSH

    Adult
    Aged
    Celiac Disease
    Crohn Disease
    Diagnosis, Differential
    Diarrhea
    Female
    Gastrointestinal Motility
    Humans
    Intestinal Neoplasms
    Intestines
    Lymphoma, T-Cell
    Male
    Middle Aged
    Reference Values
    Ultrasonography

    Pub Type(s)

    Journal Article

    Language

    ger

    PubMed ID

    10670069

    Citation

    Dietrich, C F., et al. "[Intestinal B-mode Sonography in Patients With Endemic Sprue. Intestinal Sonography in Endemic Sprue]." Ultraschall in Der Medizin (Stuttgart, Germany : 1980), vol. 20, no. 6, 1999, pp. 242-7.
    Dietrich CF, Brunner V, Seifert H, et al. [Intestinal B-mode sonography in patients with endemic sprue. Intestinal sonography in endemic sprue]. Ultraschall Med. 1999;20(6):242-7.
    Dietrich, C. F., Brunner, V., Seifert, H., Schreiber-Dietrich, D., Caspary, W. F., & Lembcke, B. (1999). [Intestinal B-mode sonography in patients with endemic sprue. Intestinal sonography in endemic sprue]. Ultraschall in Der Medizin (Stuttgart, Germany : 1980), 20(6), pp. 242-7.
    Dietrich CF, et al. [Intestinal B-mode Sonography in Patients With Endemic Sprue. Intestinal Sonography in Endemic Sprue]. Ultraschall Med. 1999;20(6):242-7. PubMed PMID: 10670069.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - [Intestinal B-mode sonography in patients with endemic sprue. Intestinal sonography in endemic sprue]. AU - Dietrich,C F, AU - Brunner,V, AU - Seifert,H, AU - Schreiber-Dietrich,D, AU - Caspary,W F, AU - Lembcke,B, PY - 2000/2/12/pubmed PY - 2000/3/4/medline PY - 2000/2/12/entrez SP - 242 EP - 7 JF - Ultraschall in der Medizin (Stuttgart, Germany : 1980) JO - Ultraschall Med VL - 20 IS - 6 N2 - AIM: The value of ultrasonography in the diagnosis, follow-up and for the detection of complications in patients with celiac sprue has not yet been sufficiently evaluated. A pronounced back and forth motility with echo-rich hump reflexes in a fluid-filled small bowel with a reduction of Kerckring's plicae circulares and with a loss of their density and uniformity was empirically defined as a diagnostic sign of celiac sprue. In the present study, the sonographic signs of celiac sprue were examined as an indicator of active sprue. METHOD: 50 patients with histologically proven celiac sprue were examined with real time ultrasonography (3.5-7 MHz). The detection or exclusion of the defined sonographic signs of celiac sprue with intensified motility and reduction of Kerckring's plicae circulares with a loss of their density and uniformity were evaluated by two independent examiners and documented without knowledge of the clinical findings. The clinical activity (active vs. remission) was assessed according to clinical criteria (diarrhea, steatorrhea, weight loss). 38 healthy subjects and 50 patients with Crohn's disease served as controls. RESULTS: In all 138 patients and controls adequate visualization of the bowel was achieved. In 16/50 (32%) patients with active celiac sprue changes of motility and reduction of Kerckring's plicae circulares with a loss of their density and uniformity were detected, whereas all 34/50 (68%) of patients with celiac sprue in remission did not have this pattern. In none of the controls with Crohn's disease or in the healthy subjects comparative sonographic signs of active celiac sprue were observed. In four patients with active celiac sprue a circumscript echopoor tumor of the small bowel wall could be sonographically detected, which turned out to be T-cell lymphoma in three and a carcinoma of the small intestine in one patient. An increased number of and/or enlarged mesenteric lymph nodes were found in patients with active celiac sprue. CONCLUSION: Changes of motility and reduction of Kerckring's plicae circulares with loss of density and uniformity at ultrasonography are a reliable indicator of active celiac sprue. SN - 0172-4614 UR - https://www.unboundmedicine.com/medline/citation/10670069/[Intestinal_B_mode_sonography_in_patients_with_endemic_sprue__Intestinal_sonography_in_endemic_sprue]_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-1999-8921 DB - PRIME DP - Unbound Medicine ER -