Background
Evaluation of the small bowel, which makes up about three-fourths of the length of the gastrointestinal tract, can be difficult for even the most experienced radiologist, and made even more difficult in fast-paced work environments like the Emergency Department. Evaluation is further complicated by the fact that patient presentation relating to small bowel pathology tends to be nonspecific, and the range of potential diagnoses is vast. Diagnostic imaging also has the power to reveal early signs of pathology before clinical signs and symptoms arise, giving the opportunity to diagnose before other methods, such as endoscopy, have even been considered.
Educational Goals / Teaching Points
1) Review common, albeit nonspecific, presenting signs and symptoms associated with small bowel pathologies. 2) Review small bowel pathology differential diagnoses based on presenting symptomatology. 3) Describe the imaging features associated with the described small bowel pathologies on various imaging modalities.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit describes the clinical presentation and imaging findings associated with processes including: a) small bowel obstruction and it's various causes, ranging from malignancy to helminthic infection; 2) bowel wall thickening, including infection/inflammation, radiation, etc.; 3) gastrointestinal bleeding; and more. Multimodality imaging findings - including CT, MRI, and US findings - are discussed.
Conclusion
A thorough knowledge of small bowel diseases, malignancies, and other pathologic processes, their common presenting signs and symptoms, and associated imaging findings allows the radiologist to make an accurate diagnosis and facilitates timely and appropriate patient management.
