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La radiologia medica

, Volume 117, Issue 4, pp 558–574 | Cite as

Sonography of the small bowel after oral administration of fluid: an assessment of the diagnostic value of the technique

  • P. MirkEmail author
  • R. Foschi
  • L. M. Minordi
  • A. Vecchioli Scaldazza
  • I. De Vitis
  • L. Guidi
  • L. Bonomo
Abdominal Radiology / Radiologia Addominale

Abstract

Purpose

This study was performed to assess the feasibility and possible advantages of bowel sonography after fluid filling of intestinal loops compared with conventional sonography.

Materials and methods

Forty-five consecutive patients with known or suspected coeliac disease (35 females, ten males; age range 11–65 years) prospectively underwent sonography before and after ingestion of 750 ml of an aqueous solution of polyethylene glycol. Results before and after fluid distension were compared to assess whether luminal filling improved small-bowel visualisation.

Results

Luminal filling improved visualisation of intestinal features (luminal diameter, mucosal folds, parietal layers) in 77.6% of cases (marked, moderate or mild improvement in 2, 16 and 17 patients; 4.4%, 35.5% and 37.7%), respectively, and showed no change or worsening in 20% and 2.2% nine and one patient), respectively. Baseline examination showed abnormal features in 13/25 celiac patients (dilated fluid-filled loops, increased peristalsis, transient intussusception, mesenteric lymph nodes, intraperitoneal fluid). Reexamination after luminal filling showed additional abnormalities in six of the previous 13 and in three further coeliac patients. There were no false positive signs due to fluid administration.

Conclusions

Luminal filling can improve visualisation of bowel walls and fold pattern and may be helpful in selected cases.

Keywords

Small bowel Polyethylene glycol Celiac disease Bowel wall Sonography 

Ecografia dell’intestino tenue dopo somministrazione orale di liquidi: valutazione del valore diagnostico della tecnica

Riassunto

Obiettivo

Scopo di questo lavoro è stato valutare fattibilità e possibili vantaggi dell’ecografia dell’intestino tenue dopo distensione fluida, a confronto con l’ecografia convenzionale.

Materiali e metodi

Quarantacinque pazienti (35 femmine, 10 maschi; età: 11–65 anni) con celiachia sospetta o accertata sono stati sottoposti prospetticamente ad ecografia prima e dopo somministrazione orale di 750 ml di soluzione acquosa di polietilenglicole. I risultati prima e dopo distensione fluida sono stati confrontati per valutare se tale tecnica consenta una migliore visualizzazione del tenue.

Risultati

Il riempimento fluido ha migliorato la visualizzazione del tenue (lume, pliche mucose, stratificazione parietale) nel 77,6% dei casi (miglioramento notevole, discreto, o minimo in 2, 16, e 17 pazienti; 4,4%, 35,5% e 37,7%); non ha migliorato o ha peggiorato la visualizzazione nel 20% e 2,2% (9 e 1 pazienti). L’ecografia convenzionale ha dimostrato alterazioni intestinali in 13/25 pazienti celiaci (anse dilatate, aumentata peristalsi, invaginazioni transitorie, linfoadenomegalie mesenteriche, versamento intraperitoneale). Il riempimento fluido ha mostrato ulteriori alterazioni in 6 dei precedenti 13 pazienti e in 3 ulteriori pazienti con celiachia. Non ci sono stati falsi positivi dovuti al riempimento fluido.

Conclusioni

Il riempimento fluido permette una migliore visualizzazione dell’intestino tenue e può essere indicato in casi selezionati.

Parole chiave

Intestino tenue Polietilenglicole Celiachia Parete intestinale Ecografia 

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Copyright information

© Springer-Verlag Italia 2011

Authors and Affiliations

  • P. Mirk
    • 1
    Email author
  • R. Foschi
    • 1
  • L. M. Minordi
    • 1
  • A. Vecchioli Scaldazza
    • 1
  • I. De Vitis
    • 2
  • L. Guidi
    • 2
  • L. Bonomo
    • 1
  1. 1.Dipartimento di Bio-immagini e Scienze RadiologicheUniversità Cattolica del Sacro CuoreRomaItaly
  2. 2.Dipartimento di Medicina InternaUniversità Cattolica del Sacro CuoreRomaItaly

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