• Journal of radiological science and technology
• /
• v.28 no.4
• /
• pp.279-286
• /
• 2005

Purpose : There are two modalities, those are small bowel series(SBS) and abdominal pelvic computed tomography(CT), for diagnosis of small bowel disease. The aim of this study is to lend radiological technologists who are doing the two modalities assistance in the understanding characteristic of disease by comparing the two results. Meterials and method : 284 patients were examined the two SBS and abdominal pelvic CT together from 1999 to 2003. 250 ml $BaSO_4$ suspension 40 w/v% and 600ml carboxy methyl cellulose 0.5 w/v% were used for SBS. Abdominal Pelvic CT was examined in one hour before taking 450 ml $BaSO_4$ suspension 1.5 w/v%. The CT scan was done in 72 sec after 150 ml contrast media injection. the used protocol was helical mode 5:5 mm pitch 1.375:1, speed 27.50, exposure 120 kv, 240 mA, tube rotation time 0.5 sec. the statistic analysis was conducted with statistical program SPSS 10 version with frequency and crossing analysis. P-value less than 0.05 were considered significant. Results : In the results of SBS, normal findings were 131 patients(46.1%), inflammatory bowel disease(IBD) 64(22.9%), ischemia+ileocolitis+vasculitis 22(7.7%), Obstruction+stricture 21(7.7%) and Others 45(15.9%). In the results of abdominal pelvic CT, normal findings were 103 patients(36.3%), inflammatory bowel disease 65(22.9%), wall thickening+lymphadenopathy 42(14.8%), Fluid collection 17(6%), and Others 57case(20%). The same results of the two were 130patients(45.8%). 30patients(10.6%) of normal finding in SBS were diagnosed as wall thickening+lymphadenopathy and IBD in CT, and 15patients(5.3%) of normal finding in CT were diagnosed as ischemia+ileocolitis+vasculitis, mass and IBD in SBS(p<0.05). Transit time delay was diagnosed in 10patients(3.5%) on only SBS, wall thickening+lymphadenopathy was diagnosed in 20patients(7%) in only CT(p<0.05). Conclusion : We think that proper examination method will be selected in the small bowel disease, if we understand the characteristics of the disease and method.

• Journal of the Korean Society of Radiology
• /
• v.84 no.3
• /
• pp.520-535
• /
• 2023

Gastrointestinal (GI) bleeding is not a single disease but a symptom and clinical manifestation of a broad spectrum of conditions in the GI tract. According to its clinical presentation, GI bleeding can be classified into overt, occult, and obscure types. Additionally, it can be divided into upper and lower GI bleeding based on the Treitz ligament. Variable disease entities, including vascular lesions, polyps, neoplasms, inflammation such as Crohn's disease, and heterotopic pancreatic or gastric tissue, can cause GI bleeding. CT and conventional angiographies and nuclear scintigraphy are all radiologic imaging modalities that can be used to evaluate overt bleeding. For the work-up of occult GI bleeding, CT enterography (CTE) can be the first imaging modality. For CTE, an adequate bowel distention is critical for obtaining acceptable diagnostic performance as well as minimizing false positives and negatives. Meckel's scintigraphy can be complementarily useful in cases where the diagnosis of CTE is suboptimal. For the evaluation of obscured GI bleeding, various imaging modalities can be used based on clinical status and providers' preferences.

• Journal of the Korean Society of Radiology
• /
• v.84 no.4
• /
• pp.911-922
• /
• 2023

Purpose To compare small bowel distension and side effects between a diluted polyethylene glycol (PEG) solution and a low-density (0.1% w/v) barium sulfate suspension (LDBSS) for CT enterography (CTE) preparation. Materials and Methods Total 173 consecutive patients who underwent CTE were enrolled in this study. The LDBSS (1 L) was used in 50 patients, and the diluted iso-osmotic PEG solution (1 L) was used in 123 patients. Two blinded radiologists independently scored jejunal and ileal distensions on a 5-point scale. To compare side effects between the two groups, the patients reported whether they had immediate complications after the administration of the oral contrast media. Results For ileal and jejunal distension, the diluted PEG solution showed no difference from the LDBSS for either reader (ileum: reader 1, median, 4; 4, interquartile range, 3-4; 3-4, p = 0.997; reader 2, median, 4; 4, interquartile range, 3.3-4.0; 3-4, p = 0.064; jejunum: reader 1, median, 2; 2, interquartile range, 2-3; 2-3, p = 0.560; reader 2, median, 3; 2, interquartile range, 2-3; 2-3, p = 0.192). None of the patients complained of immediate complications following administration of either of the oral contrast media. Conclusion The diluted PEG solution showed comparable bowel distension compared to LDBSS and no immediate side effects; thus, it can be a useful alternative.

• Journal of the Korean Society of Radiology
• /
• v.83 no.2
• /
• pp.400-405
• /
• 2022

Gastrointestinal stromal tumors (GISTs) are not uncommon and often cause gastrointestinal bleeding. GISTs occurring in the small intestine are occasionally difficult to identify by endoscopy and CT. In this case, the patient underwent CT three times before surgery, and the lesion was found to be located in a different area of the abdominal cavity on each CT scan. Moreover, the lesion was missed in the first two CT images because it was difficult to distinguish it from the nearby collapsed small intestine. The lesion was eventually detected through angiography; however, the correct diagnosis and treatment were delayed for 3 years because it was mistaken for a vascular malformation, which is the most common cause of obscure GI bleeding in elderly patients. This report emphasizes the need for interventional radiologists to be updated and vigilant of the angiographic features of GISTs to make an accurate diagnosis and establish a management strategy.

• Journal of the Korean Society of Radiology
• /
• v.83 no.6
• /
• pp.1380-1384
• /
• 2022

Endometrial carcinoma is a common gynecologic malignancy; however, metastasis to the small bowel is rare. Metastatic endometrial carcinoma usually occurs through local extension rather than distant metastasis. Isolated small bowel metastasis is extremely rare; further, intussusception with resultant intestinal obstruction is not common. We report the imaging findings of a patient with isolated small bowel metastasis of endometrial carcinoma with resultant jejunojejunal intussusception.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.7 no.2
• /
• pp.278-283
• /
• 2004

Meckel's diverticulum is found in about 3% of the population, often incidentally during laparotomy or at autopsy. Over 50% of patients who develop symptoms from this anomaly are younger than 2 years of age. The most common symptom of this lesion is intestinal obstruction. Rarely Meckel's diverticulum is complicated by a mesodiverticular band, which is believed to be a remnant of a vitelline artery. We report a 11-year-old girl with small bowel obstruction because of an intestinal hernia beneath the mesodiverticular band. The causative factor was a stenotic area in the terminal ileum caused by a ringlike lipovascular mesenteric band encroaching externally on the lumen. Although the incidence of mesodiverticular bands complicating Meckel's diverticulum is quite low, the rapid clinical course and the associated high mortality rate make this an important disease.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.9 no.1
• /
• pp.70-74
• /
• 2006

Isolated small bowel intussusception accounts for 10% of all pediatric intussusception. It is more common in children older than 2 years of age. Presentation usually is with vomiting and abdominal pain. Currant jelly stool and palpable mass are less frequent than typical intussusception. There are few reported cases of children with transient small bowel intussusception. We describe 3-year-old boy presented with intermittent cyclic crampy abdominal pain for 6 months was diagnosed as having recurrent transient small bowel intussusception by abdominal ultrasonography and small bowel series.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.20 no.3
• /
• pp.417-422
• /
• 2019

Hemodynamically unstable pelvic fractures show a remarkably high mortality rate of 40% to 60%. However, their standard of care remains controversial. We report here a case of a 78-year-old woman who was admitted to the Emergency Department with pelvic pain following a fall. Based on pelvic radiography, she was diagnosed with an unstable pelvic fracture. Her blood pressure was 60/40 mmHg, and owing to her unstable vital signs, emergency angiography was performed without computed tomography (CT). Both internal iliac arteries were embolized without sub-branch selection for prompt control of pelvic bleeding. Following embolization, her vital signs were stabilized. Subsequent CT revealed free intra-abdominal air, suggesting bowel perforation had occurred and necessitating emergency laparotomy. An approximately 1 cm-sized free perforation of the small intestine was identified intraoperatively, and primary closure was performed. A retroperitoneal hematoma identified intraoperatively was not explored further because it was a non-expanding and non-pulsatile mass. The patient was admitted to the Intensive Care Unit and transferred to the general ward on postoperative day 3. In this case, the hemodynamically stable pelvic fracture with bowel perforation was successfully and safely treated by prompt angioembolization without conducting CT.

• The Journal of the Korea Contents Association
• /
• v.10 no.6
• /
• pp.336-343
• /
• 2010

Coronary artery CT angiography has short scanning length, the exposure dose is high. Therefore, it is required to study on the organ dose when using MDCT. We compared the differences between the absorbed dose and effective dose in the major organs assessing the absorbed dose in the major organs by 16-MDCT and 64-MDCT in the subjects with coronary artery CT angiography, the same protocol by 16-MDCT and 64-MDCT. As a result, the great orders of absorbed dose when conducting coronary artery CT angiography had been shown as heart, stomach, liver, pancreas, kidney, spleen, large intestine, lung, small intestine, thyroid gland, ovary, bladder, and orbit with the absorbed dose distribution of $0.538{\pm}0.026(Mean{\pm}SD,\;p<0.05)mGy{\sim}71.316{\pm}4.316mGy$ in 16-MDCT, and heart, stomach, pancreas, spleen, liver, kidney, small intestine, large intestine, lung, thyroid gland, ovary, bladder, and orbit with the absorbed dose distribution of $0.87{\pm}0.01mGy{\sim}115.26{\pm}1.59mGy$ in 64-MDCT, demonstrating some different distributions. The exposed doses to the patient per one time scanning with coronary artery CT angiography were $71.316{\pm}4.316mGy$ in 16-MDCT as the absorbed dose based on the heart and $115.26{\pm}1.59mGy$ in 64-MDCT. The effective doses were 7.41 mSv and 12.11 mSv in 16 and 64-MDCT, respectively. Taking into account the results of brain CT with 2.8 mSv that has comparatively large scanning length and size, facial CT 0.8 mSv, chest CT 5.7 mSv, pelvic CT 7.2 mSv, and abdominal and pelvic CT 14.4 mSv, it is very high considering the scanning length of 13 cm limited to the heart for the scanning range.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.5 no.1
• /
• pp.88-90
• /
• 2002

Chilaiditi's sign is a radiographic term used when the hepatic flexure of colon is seen interposed between the liver and right hemidiaphragm. Mostly asymptomatic, Chilaiditi's syndrome can present with abdominal pain, nausea, vomiting, anorexia, abdominal distension, tender hepatomegaly and change in bowel habits. Uncommon in childhood, the incidence seems to increase with age. We have experienced a case of Chilaiditi's syndrome presenting with vomiting in a 15-month-old boy. The patient recovered uneventfully.