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Vol. 63. Issue 6.
Pages 519-530 (November - December 2021)
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Vol. 63. Issue 6.
Pages 519-530 (November - December 2021)
Article from a resident
Diagnostic approach to small-bowel wall thickening: Beyond Crohn’s disease and cancer
Aproximación diagnóstica al engrosamiento parietal del intestino delgado: más allá de la enfermedad de Crohn y el cáncer
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E. Marín-Díez
Corresponding author
elenamarindiez@gmail.com

Corresponding author.
, J. Crespo del Pozo
Servicio de Radiodiagnóstico, Hospital Universitario Marqués de Valdecilla, Santander, Spain
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Abstract

Although small-bowel wall thickening is a common manifestation of Crohn’s disease and tumors, many other entities can give rise to similar imaging findings. The small bowel is difficult to access by endoscopy, so radiologic imaging tests play an essential role in the diagnosis of conditions involving the small bowel. The main objectives of this paper are to explain the definition of small-bowel wall thickening, analyze the patterns of involvement seen in multidetector computed tomography (MDCT) with intravenous contrast administration, and provide an image-based review of the different causes of small-bowel wall thickening. The differential diagnosis must include many entities because wall thickening can result from immune-mediated, infectious, or vascular causes, as well as from toxicity and other lesser-known entities. As the imaging appearance of many of these conditions overlap, clinical and laboratory findings are necessary to support the imaging diagnosis.

Keywords:
Multidetector computed tomography
Small intestine
Contrast medium
Enteritis
Mesenteric ischemia
Eosinophilic enteropathy
Immunoproliferative small intestinal disease
Resumen

El engrosamiento parietal del intestino delgado es una manifestación frecuente en la enfermedad de Crohn y en las neoplasias, aunque muchas otras entidades pueden presentar hallazgos de imagen similares. El intestino delgado es poco accesible mediante el examen endoscópico, por lo que las pruebas de imagen radiológicas tienen un papel esencial en el diagnóstico. En este trabajo, nuestros objetivos principales fueron explicar la definición de engrosamiento del intestino delgado, estudiar los patrones de afectación en la tomografía computarizada multidetector (TCMD) con contraste intravenoso (CIV) y proporcionar una revisión, basada en imágenes, de las diferentes causas de engrosamiento de intestino delgado. El diagnóstico diferencial es amplio y complicado, ya que existen causas inmunomediadas, infecciosas y vasculares, casos de toxicidad y otras entidades más desconocidas. Como la apariencia radiológica de muchas de estas enfermedades puede superponerse, se necesitan datos clínicos y analíticos para apoyar nuestro diagnóstico.

Palabras clave:
Tomografía computarizada multidector
Intestino delgado
Medio de contraste
Enteritis
Isquemia mesentérica
Enteropatía eosinofílica
Enfermedad inmunoproliferativa de intestino delgado

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