GI Radiology > Stomach > Inflammatory Disorders

Inflammatory Disorders

Crohn's Disease

Crohn's disease, also termed regional enteritis, is a chronic inflammatory condition that may involve any area of the GI tract from the mouth to the anus. The etiology remains unknown; however, possible factors include infection, altered immunity, and genetic predisposition. Patients are typically under 30 years of age and present with abdominal pain, fever, nausea, vomiting, weight loss, and diarrhea (often bloody).

Classic features include:

  • Aphthoid lesions
  • Transmural inflammation with granulomas
  • Ulceration with “cobblestoning”
  • Fissure and fistula formation
  • Strictures
  • Sharply demarcated involved bowel segments with intervening normal areas (skip lesions)
  • Rectal sparing

 

The small bowel is the most commonly affected portion of the gastrointestinal tract, occurring in 80% of patients, with the terminal ileum being the most frequently involved segment. Gastric involvement is seen in only 5% of patients.

 

Radiographic Findings: UGIS

  • Thick, distorted mucosal folds

  • Aphthoid lesions

  • Linear or serpiginous ulcers creating a mucosal “cobblestone” appearance

  • Funnel-shaped antral stenosis with narrowing of the proximal duodenum

The above barium study from a patient with known Crohn's shows a serrated appearance of the antrum (arrows) due to inflammatory involvement from Crohn's.

 

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