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Fluoroscopic Techniques for the Interrogation of IBD Patients

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Endoscopy in Inflammatory Bowel Disease

Abstract

Fluoroscopic imaging of the gut has provided critical information for the care of inflammatory bowel disease patients since the days of Dr. Burrill Crohn. With the advent of new optical and cross-sectional imaging techniques, biologic and immunologic therapies, and surgical techniques, the role of fluoroscopy in inflammatory bowel disease management has evolved. This chapter reviews different types of fluoroscopic exams, their strengths and weaknesses, with an emphasis on highlighting unique information they provide compared to cross-sectional alternatives. Radiographic signs indicating active, penetrating, and obstructive disease are reviewed, with diagnostic pitfalls in cross-sectional imaging that can be addressed with fluoroscopic exams highlighted. The complementary role of fluoroscopy to optical and cross-sectional imaging techniques is discussed throughout.

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References

  1. Crohn BB, Ginzburg L, Oppenheimer GD. Regional ileitis: a pathologic and clinical entity. JAMA. 1932;99(16):1323–9.

    Article  Google Scholar 

  2. Marshak RH. Granulomatous disease of the intestinal tract (crohn’s disease). Radiology. 1975;114(1):3–22.

    Article  CAS  PubMed  Google Scholar 

  3. Cellier C, Sahmoud T, Froguel E, Adenis A, Belaiche J, Bretagne JF, et al. Correlations between clinical activity, endoscopic severity, and biological parameters in colonic or ileocolonic crohn’s disease. A prospective multicentre study of 121 cases. The groupe d’etudes therapeutiques des affections inflammatoires digestives. Gut. 1994;35(2):231–5.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  4. Bruining DH, Loftus EV, Jr., Ehman EC, Siddiki HA, Nguyen DL, Fidler JL, et al. Computed tomography enterography detects intestinal wall changes and effects of treatment in patients with crohn’s disease. Clin Gastroenterol Hepatol. 2011;9(8):679–683 e671.

    Google Scholar 

  5. Levine MS, Trenkner SW. Training the next generation in luminal gastrointestinal radiology: a call to arms. Am J Roentgenol. 2011;196(2):362–6.

    Article  Google Scholar 

  6. Maglinte DDT, Gourtsoyiannis N, Rex D, Howard TJ, Kelvin FM. Classification of small bowel crohn’s subtypes based on multimodality imaging. Radiol Clin North Am. 2003;41(2):285–303.

    Google Scholar 

  7. Gore RM, Levine MS. Textbook of gastrointestinal radiology. Philadelphia, PA: Saunders; 2008.

    Google Scholar 

  8. Marshak GH, Wolf BS. Roentgen findings in regional enteritis. Am J Roentgenol Radium Ther Nucl Med. 1955;74(6):1000–14.

    CAS  PubMed  Google Scholar 

  9. Herlinger H, Rubesin SE, Furth EE. Mesenteric border linear ulcer in crohn disease: historical, radiologic, and pathologic perspectives. Abdom Imaging. 1998;23(2):122–6.

    Article  CAS  PubMed  Google Scholar 

  10. Hizawa K, lida M, Kohrogi N, Kuroki F, Yao T, Sakamoto K, et al. Crohn disease: early recognition and progress of aphthous lesions. Radiolgy. 1994;190:451–454.

    Google Scholar 

  11. Laufer I, Costopoulos L. Early lesions of crohn’s disease. AJR Am J Roentgenol. 1978;130:307–11.

    Article  CAS  PubMed  Google Scholar 

  12. Vogel J, da Luz MA, Baker M, Hammel J, Einstein D, Stocchi L, et al. Ct enterography for crohn’s disease: Accurate preoperative diagnostic imaging. Dis Colon Rectum. 2007;50(11):1761–9.

    Article  PubMed  Google Scholar 

  13. Dave-Verma H, Moore S, Singh A, Martins N, Zawacki J. Computed tomographic enterography and enteroclysis: Pearls and pitfalls. Curr Probl Diagn Radiol. 2008;37(6):279–287.

    Google Scholar 

  14. Solem CA, Loftus EV, Fletcher JG, Baron TH, Gostout CJ, Petersen BT, et al. Small-bowel imaging in crohn’s disease: A prospective, blinded, 4-way comparison trial. Gastrointest Endosc. 2008;68(2):255–66.

    Article  PubMed  Google Scholar 

  15. Wold PB, Fletcher JG, Johnson CD, Sandborn WJ. Assessment of small bowel crohn disease: Noninvasive peroral ct enterography compared with other imaging methods and endoscopy - feasibility study. Radiology. 2003;229(1):275–81.

    Article  PubMed  Google Scholar 

  16. Albert JG, Martiny F, Krummenerl A, Stock K, Lesske J, Gobel CM, et al. Diagnosis of small bowel crohn’s disease: A prospective comparison of capsule endoscopy with magnetic resonance imaging and fluoroscopic enteroclysis. Gut. 2005;54(12):1721–1727.

    Google Scholar 

  17. Lee SS, Kim AY, Yang SK, Chung JW, Kim SY, Park SH, et al. Crohn disease of the small bowel: Comparison of ct enterography, mr enterography, and small-bowel follow-through as diagnostic techniques. Radiology. 2009;251(3):751–61.

    Article  PubMed  Google Scholar 

  18. Levesque BG, Cipriano LE, Chang SL, Lee KK, Owens DK, Garber AM. Cost effectiveness of alternative imaging strategies for the diagnosis of small-bowel crohn’s disease. Clin Gastroenterol Hepatol. 2010;8(3):261–7.

    Article  PubMed  Google Scholar 

  19. Shatari T, Clark MA, Lee JR, Keighley MRB. Reliability of radiographic measurement of small intestinal length. Colorectal Dis. 2004;6:327–9.

    Article  CAS  PubMed  Google Scholar 

  20. Booya F, Akram S, Fletcher JG, Huprich JE, Johnson CD, Fidler JL, et al. Ct enterography and fistulizing crohn’s disease: Clinical benefit and radiographic findings. Abdom Imaging. 2009;34(4):467–75.

    Article  PubMed  Google Scholar 

  21. http://www.acr.org/~/media/ACR/Documents/PGTS/guidelines/Enteroclysis.pdf. Accessed 2014 Apr 9.

  22. Maglinte DD, Kohli MD, Romano S, Lappas JC. Air (co2) double-contrast barium enteroclysis. Radiology. 2009;252:633–41.

    Article  PubMed  Google Scholar 

  23. Rajesh A, Sandrasegaran K, Jennings SG, Maglinte DD, McHenry L, Lappas JC, et al. Comparison of capsule endoscopy with enteroclysis in the investigation of small bowel disease. Abdom Imaging. 2009;34(4):459–66.

    Article  PubMed  Google Scholar 

  24. Chiorean MV, Sandrasegaran K, Saxena R, Maglinte DD, Nakeeb A, Johnson CS. Correlation of ct enteroclysis with surgical pathology in crohn’s disease. Am J Gastroenterol. 2007;102(11):2541–50.

    Article  PubMed  Google Scholar 

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Correspondence to Joel G. Fletcher MD .

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Trenkner, S.W., Fletcher, J.G. (2015). Fluoroscopic Techniques for the Interrogation of IBD Patients. In: Kozarek, R., Chiorean, M., Wallace, M. (eds) Endoscopy in Inflammatory Bowel Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-11077-6_3

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  • DOI: https://doi.org/10.1007/978-3-319-11077-6_3

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-11076-9

  • Online ISBN: 978-3-319-11077-6

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