|
|
| Line 12: |
Line 12: |
|
| |
|
| ==Other Imaging findings== | | ==Other Imaging findings== |
| ===Endoscopy===
| |
| [[Image:celiac_3.jpg|left|thumb|200px|[[Endoscopy|Endoscopic]] still of [[duodenum]] of patient with coeliac disease showing scalloping of folds.]]
| |
| An [[upper endoscopy]] with [[biopsy]] of the [[duodenum]] (beyond the [[duodenal bulb]]) or [[jejunum]] is performed. It is important for the physician to obtain multiple samples (four to eight) from the duodenum. Not all areas may be equally affected; if biopsies are taken from healthy bowel, it would result in false negative results.
| |
|
| |
|
| Most patients with coeliac disease have a small bowel that appears normal on endoscopy; however, five endoscopic findings have been associated with a high specificity for coeliac disease when all are found: scalloping of the small bowel folds (''pictured''), paucity in the folds, a mosaic pattern to the [[mucosa]] (described as a ''cracked-mud'' appearance), prominence of the submucosal blood vessels and a nodular pattern to the mucosa.<ref>{{cite journal | author = Niveloni S, Fiorini A, Dezi R, Pedreira S, Smecuol E, Vazquez H, Cabanne A, Boerr LA, Valero J, Kogan Z, Maurino E, Bai JC. | title = Usefulness of videoduodenoscopy and vital dye staining as indicators of mucosal atrophy of celiac disease: assessment of interobserver agreement | journal = Gastrointestinal Endoscopy | volume = 47 | issue = 3 | pages = 223–229 | year = 1998 | id = PMID 9580349}}</ref>
| |
|
| |
| Until the 1970s, biopsies were obtained using metal capsules attached to a suction device. The capsule was swallowed and allowed to pass into the small intestine. After X-ray verification of its position, suction was applied to collect part of the intestinal wall inside the capsule. One much utilized capsule system is the [[Watson capsule]]. This method has now been largely replaced by fiberoptic endoscopy, which carries a higher sensitivity rate and a lower error frequency.<ref>{{cite journal |author=Mee A, Burke M, Vallon A, Newman J, Cotton P |title=Small bowel biopsy for malabsorption: comparison of the diagnostic adequacy of endoscopic forceps and capsule biopsy specimens |journal=Br Med J (Clin Res Ed) |volume=291 |issue=6498 |pages=769-72 |year=1985 |pmid=3929934}}</ref>
| |
|
| |
| <br clear="left"/>
| |
| Fluoroscopy | | Fluoroscopy |
| Features of small bowel barium studies are not sensitive enough for confident diagnosis, but the following changes may be seen: | | Features of small bowel barium studies are not sensitive enough for confident diagnosis, but the following changes may be seen: |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
There are no other imaging findings associated with [disease name].
OR
[Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
Other Imaging findings
Fluoroscopy
Features of small bowel barium studies are not sensitive enough for confident diagnosis, but the following changes may be seen:
small intestinal dilatation due to excess fluid
dilution of contrast
multiple non-obstructing intussusceptions
jejunoileal fold pattern reversal
moulage sign
mosaic pattern
flocculation
segmentation
References
Template:WH
Template:WS