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Small bowel imaging in celiac disease.
Dig Dis 2015; 33(2):252-9DD

Abstract

BACKGROUND

Modern small bowel imaging techniques allow detailed depiction of small-intestinal abnormalities. The role of these techniques in the investigation of celiac disease is increasing, especially in patients with suspected complicated celiac disease.

KEY MESSAGES

In general, there is no need for radiological small bowel imaging in uncomplicated celiac disease. It is however important that clinicians and radiologists are aware of certain specific radiological findings that may suggest celiac disease, especially since celiac disease is often not considered in adult patients, and small bowel radiology may be performed before specific tests for celiac disease. Radiological abnormalities can be observed with both conventional small bowel radiology studies, like small bowel follow-through or double-contrast small bowel enteroclysis, and newer modalities, like computed tomography or magnetic resonance enterography or enteroclysis. These signs include a decreased number of jejunal folds, an increased number of ileal folds, small bowel dilatation, wall thickening and intussusception. Extraintestinal abnormalities include mesenteric lymphadenopathy, vascular changes and splenic atrophy. Abnormalities congruent with refractory celiac disease type II include a severe decrease in jejunal folds, infiltration of the mesenteric fat and thickening of the small bowel wall. Additionally, a severely decreased splenic volume may indicate complicated celiac disease. Malignant complications of celiac disease, such as enteropathy-associated T-cell lymphoma and small-intestinal adenocarcinoma, can be reliably investigated with cross-sectional enteroclysis techniques.

CONCLUSIONS

Small bowel imaging and especially cross-sectional enteroclysis techniques are important extensions to the diagnostic workup of clinicians involved in the care of patients with celiac disease, especially those with suspected complicated disease.

Authors+Show Affiliations

Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

25925931

Citation

Van Weyenberg, Stijn J B., et al. "Small Bowel Imaging in Celiac Disease." Digestive Diseases (Basel, Switzerland), vol. 33, no. 2, 2015, pp. 252-9.
Van Weyenberg SJ, Mulder CJ, Van Waesberghe JH. Small bowel imaging in celiac disease. Dig Dis. 2015;33(2):252-9.
Van Weyenberg, S. J., Mulder, C. J., & Van Waesberghe, J. H. (2015). Small bowel imaging in celiac disease. Digestive Diseases (Basel, Switzerland), 33(2), pp. 252-9. doi:10.1159/000369516.
Van Weyenberg SJ, Mulder CJ, Van Waesberghe JH. Small Bowel Imaging in Celiac Disease. Dig Dis. 2015;33(2):252-9. PubMed PMID: 25925931.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Small bowel imaging in celiac disease. AU - Van Weyenberg,Stijn J B, AU - Mulder,Chris J J, AU - Van Waesberghe,Jan Hein T M, Y1 - 2015/04/22/ PY - 2015/5/1/entrez PY - 2015/5/1/pubmed PY - 2016/1/27/medline SP - 252 EP - 9 JF - Digestive diseases (Basel, Switzerland) JO - Dig Dis VL - 33 IS - 2 N2 - BACKGROUND: Modern small bowel imaging techniques allow detailed depiction of small-intestinal abnormalities. The role of these techniques in the investigation of celiac disease is increasing, especially in patients with suspected complicated celiac disease. KEY MESSAGES: In general, there is no need for radiological small bowel imaging in uncomplicated celiac disease. It is however important that clinicians and radiologists are aware of certain specific radiological findings that may suggest celiac disease, especially since celiac disease is often not considered in adult patients, and small bowel radiology may be performed before specific tests for celiac disease. Radiological abnormalities can be observed with both conventional small bowel radiology studies, like small bowel follow-through or double-contrast small bowel enteroclysis, and newer modalities, like computed tomography or magnetic resonance enterography or enteroclysis. These signs include a decreased number of jejunal folds, an increased number of ileal folds, small bowel dilatation, wall thickening and intussusception. Extraintestinal abnormalities include mesenteric lymphadenopathy, vascular changes and splenic atrophy. Abnormalities congruent with refractory celiac disease type II include a severe decrease in jejunal folds, infiltration of the mesenteric fat and thickening of the small bowel wall. Additionally, a severely decreased splenic volume may indicate complicated celiac disease. Malignant complications of celiac disease, such as enteropathy-associated T-cell lymphoma and small-intestinal adenocarcinoma, can be reliably investigated with cross-sectional enteroclysis techniques. CONCLUSIONS: Small bowel imaging and especially cross-sectional enteroclysis techniques are important extensions to the diagnostic workup of clinicians involved in the care of patients with celiac disease, especially those with suspected complicated disease. SN - 1421-9875 UR - https://www.unboundmedicine.com/medline/citation/25925931/Small_bowel_imaging_in_celiac_disease_ L2 - https://www.karger.com?DOI=10.1159/000369516 DB - PRIME DP - Unbound Medicine ER -