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Cystic Fibrosis below the Diaphragm: Abdominal Findings in Adult Patients.
Radiographics 2015 May-Jun; 35(3):680-95R

Abstract

Cystic fibrosis (CF) is the most common lethal autosomal recessive disease in the white population. Mutation of the CF transmembrane conductance regulator gene on chromosome 7 results in production of abnormally viscous mucus and secretions in the lungs of patients with CF. A similar pathologic process occurs in the gastrointestinal tract, pancreas, and hepatobiliary system. Inspissated mucus causes luminal obstruction and resultant clinical and radiologic complications associated with the disease process. Pancreatic involvement can result in exocrine and endocrine insufficiency, pancreatic atrophy, fatty replacement, or lipomatous pseudohypertrophy. Acute and chronic pancreatitis, pancreatic calcification, cysts, and cystosis also occur. Hepatic manifestations include hepatic steatosis, focal biliary and multilobular cirrhosis, and portal hypertension. Biliary complications include cholelithiasis, microgallbladder, and sclerosing cholangitis. The entire digestive tract can be involved. Distal ileal obstruction syndrome, intussusception, appendicitis, chronic constipation, colonic wall thickening, fibrosing colonopathy, pneumatosis intestinalis, gastroesophageal reflux, and peptic ulcer disease have been described. Renal manifestations include nephrolithiasis and secondary amyloidosis. The educational objectives of this review are to reveal the abdominal manifestations of CF to facilitate focused analysis of cross-sectional imaging in adult patients. Life expectancy in patients with CF continues to improve because of a combination of aggressive antibiotic treatment, improved emphasis on nutrition and physiotherapy, and development of promising new CF transmembrane conductance regulator modulators. As lung function and survival improve, extrapulmonary conditions, including hepatic and gastrointestinal malignancy, will be an increasing cause of morbidity and mortality. Awareness of the expected abdominal manifestations of CF may assist radiologists in identifying acute inflammatory or neoplastic conditions. (©)RSNA, 2015.

Authors+Show Affiliations

From the Department of Radiology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

25910185

Citation

Lavelle, Lisa P., et al. "Cystic Fibrosis Below the Diaphragm: Abdominal Findings in Adult Patients." Radiographics : a Review Publication of the Radiological Society of North America, Inc, vol. 35, no. 3, 2015, pp. 680-95.
Lavelle LP, McEvoy SH, Ni Mhurchu E, et al. Cystic Fibrosis below the Diaphragm: Abdominal Findings in Adult Patients. Radiographics. 2015;35(3):680-95.
Lavelle, L. P., McEvoy, S. H., Ni Mhurchu, E., Gibney, R. G., McMahon, C. J., Heffernan, E. J., & Malone, D. E. (2015). Cystic Fibrosis below the Diaphragm: Abdominal Findings in Adult Patients. Radiographics : a Review Publication of the Radiological Society of North America, Inc, 35(3), pp. 680-95. doi:10.1148/rg.2015140110.
Lavelle LP, et al. Cystic Fibrosis Below the Diaphragm: Abdominal Findings in Adult Patients. Radiographics. 2015;35(3):680-95. PubMed PMID: 25910185.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cystic Fibrosis below the Diaphragm: Abdominal Findings in Adult Patients. AU - Lavelle,Lisa P, AU - McEvoy,Sinead H, AU - Ni Mhurchu,Elaine, AU - Gibney,Robert G, AU - McMahon,Colm J, AU - Heffernan,Eric J, AU - Malone,Dermot E, Y1 - 2015/04/24/ PY - 2015/4/25/entrez PY - 2015/4/25/pubmed PY - 2016/2/18/medline SP - 680 EP - 95 JF - Radiographics : a review publication of the Radiological Society of North America, Inc JO - Radiographics VL - 35 IS - 3 N2 - Cystic fibrosis (CF) is the most common lethal autosomal recessive disease in the white population. Mutation of the CF transmembrane conductance regulator gene on chromosome 7 results in production of abnormally viscous mucus and secretions in the lungs of patients with CF. A similar pathologic process occurs in the gastrointestinal tract, pancreas, and hepatobiliary system. Inspissated mucus causes luminal obstruction and resultant clinical and radiologic complications associated with the disease process. Pancreatic involvement can result in exocrine and endocrine insufficiency, pancreatic atrophy, fatty replacement, or lipomatous pseudohypertrophy. Acute and chronic pancreatitis, pancreatic calcification, cysts, and cystosis also occur. Hepatic manifestations include hepatic steatosis, focal biliary and multilobular cirrhosis, and portal hypertension. Biliary complications include cholelithiasis, microgallbladder, and sclerosing cholangitis. The entire digestive tract can be involved. Distal ileal obstruction syndrome, intussusception, appendicitis, chronic constipation, colonic wall thickening, fibrosing colonopathy, pneumatosis intestinalis, gastroesophageal reflux, and peptic ulcer disease have been described. Renal manifestations include nephrolithiasis and secondary amyloidosis. The educational objectives of this review are to reveal the abdominal manifestations of CF to facilitate focused analysis of cross-sectional imaging in adult patients. Life expectancy in patients with CF continues to improve because of a combination of aggressive antibiotic treatment, improved emphasis on nutrition and physiotherapy, and development of promising new CF transmembrane conductance regulator modulators. As lung function and survival improve, extrapulmonary conditions, including hepatic and gastrointestinal malignancy, will be an increasing cause of morbidity and mortality. Awareness of the expected abdominal manifestations of CF may assist radiologists in identifying acute inflammatory or neoplastic conditions. (©)RSNA, 2015. SN - 1527-1323 UR - https://www.unboundmedicine.com/medline/citation/25910185/Cystic_Fibrosis_below_the_Diaphragm:_Abdominal_Findings_in_Adult_Patients_ L2 - http://pubs.rsna.org/doi/10.1148/rg.2015140110?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -