Journal List > J Korean Radiol Soc > v.13(1) > 1137751

Yoo, Oh, and Choi: Radiologic evaluation of inflammatory bowel disease

Abstract

Inflammatory bowel disease are prevalent in Korea, especially intestinal Tbc and amebiasis, while sometimes wehave met the Crohn's disease and ulcerative colitis. There seems to be many difficulties to differentiate theseinflammatory bowel disease through clinical and radiographical findings. However, the radiographical findings showthe site and extent of involvement and the pattern of mucosal changes to differentiate the other disease.Therefore, the diagnosis of inflammatory bowel disease are possible in many instances when specific criteria areapplied to the barium enema examination. In a review of 126 cases of proven inflammatory bowel disease inSeverance hospital over the period of 1966-1976, we have analysed the specific findings of each inflammatory boweldisease regarding on the motility, site and extent of involvement, pattern of mucosal changes including ulcerationand changes of the ileocecal value. Result follows ; 1. The incidence of each inflammatory bowel disease are; Tbcintestine (65%), Amebic colitis (15.8%), Ulcerative colitis (11.1%) and Crohn's disease (7.1%) . 2. Tbc intestineand Crohn's disease are prevalent in young females, while amebic and ulcerative colitis in old males. There are 3cases (25%) of Crohn's disease who have operated under the impression of acute appendicitis due to abdominal painand obstruction. 3. 49% of intestinal Tbc patients have had pulmonary tbc., among them 25% had moderately advancedactive pulmonary Tbc and 15% in the state of far advanced active. 4. It was helpful to delineate the abnormalitesfrom post evacuation film in Tbc instestine, double air contrast study in Crohn's disease and filling study inamebiasis and ulcerative colitis. 5. The findings of intestinal Tbc show; intestinal lymph node calcification(10.9%), shortening extrinsic mass effect (60.9%). Frequent shallow ulceration, widening and elongation ofileocecal valve and cobble stone appearance of involved mucosa with spasm are specific findings. 6. Crohn'sdisease shows less spasm of bowels, more frequent deep ulceration, more distortion and mucosa thickening than theintestinal Tbc. Mesenteric border seems to be more eccentrically involved than antemesenteric border. 7, Amebiccolitis showed specific collar button ulceration, deformity of cecum without involvement of terminal ileum andfuziness in bowel due to secretion. 8. Ulcerative colitis showed various pattern of ulcerations such as shallow,collar button, deep ulcers and among which shallow ulcerations were most frequent finding. There were 1 case oftoxic megacolon and 3 cases of associated carcinoma in ulcerative colitis.

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