Crohn Hastalığında Multidedektör Bilgisayarlı Tomografi Bulguları

Yıl 2009, Cilt: 42 Sayı: 2, 69 - 73, 01.08.2009

Kemal Arda Nazan Çiledağ

Öz

Crohn's disease is an idiopathic inflammatory bowel disease. Multidedector computed tomography is used in diagnoses and the management of the intramural, murat and extramural components of the gastrointestinal tract pathologies. VVith unknown eti-ology, and has variabie responses to medical and surgical management. Barium studies and colonoscopy are the primary evaluation methods of the inflammatory changes of the mucosa; however, both of them provide little information on the extraintesti-nal extent of the disease. İn recent years, multidedector computed tomography became an important modality to evaluate the pathologic changes of the intraluminal, intramural, and mesenteric extent of the disease, and the attachment of the adjacent structures. Fourty-one patients (11 women, 30 men, age range 22-75 years, mean age 43.97 ± 13.96) with histological proven Crohn's disease were examined with multidedector computed tomography. İn the computed tomography studies of 41 Crohn's disease patients, segmental small bowel wall thickening were detected in 31 out of 41 cases (75.6%) , the thickening involved the terminal ileum were in 14 out of 41 (34.1 %) patients, and the different extends of the colonic wall thickening were detected in 21 out of 41 (51.2%) cases. Both small and large bowel loops were involved in 11 out of 41 (26.8%) Crohn's disease patients. Abscesses were found in four out of 41 (9.7%) Crohn's disease patients. Enlarged mesenteric lymph nodes were detected in 17 (41.4%) of them. Fistulas were detected in 8 out of 41 (19.5%>) patients, five of them ıvere enterocutaneus, two of them were enterovesical fistulas, and one was bilioenteric fistula. Perforation was seen in one of the patients and right hemicolectomy was performed.

Anahtar Kelimeler

Crohn's disease, inflammatory bowel disease, MDCT.

Multidedector Computed Tomography Findings of Crohn 's Disease

Öz

inflamatuvar bağırsak hastalıklarından Crohn hastalığının tanı ve takibinde ince kesit multidedektör bilgisayarlı tomografi görüntülemeyle gastrointestinal trakt patolojilerinin intraluminal, mu rai ve ekstraluminal komponentlerinin birlikte değerlendirmesi yapılabilmektedir. Baryumlu grafiler ve endoskopik inceleme, mukozaI inflamasyonun primer inceleme yöntemleridir. Ancak bu yöntemler kullanılarak ekstramukozal ve mezenterik patolojiler değerlendirilemez. Multidedektör bilgisayarlı tomografi ile Crohn hastalığının ekstramukozal, mezenterik komponentleri, komşu organ tutulumu, gelişen komplikasyonlar ile olguların tedaviye yanıtı ortaya konabilir. Crohn hastalığı ön tanısıyla takip edilen 41 olgunun (30 erkek, 11 kadın; yaş aralığı 22-75, ortalama yaş: 43.97 ± 13.96) multidedektör bilgisayarlı tomografi bulgulan sunulmuştur. Kırk bir olgunun 31 (%75.6)'inde ince bağırsakta, 14 (%34.1)'ünde terminal ileumda, 21 (%51.2)'inde kolonda duvar kalınlaşması, 11 (%26.8)'inde hem ince, hem de kalın bağırsak segmentlerinde tutulum, 4 (%9.7)'ünde apse, 17 (%41,4)'sinde mesenterik lenfadenopati, 8 (%19.5)'inde fistül saptanmıştır. Fistül saptanan olgulardan beşinde enterokütanöz, ikisinde enterovezikal ve birinde bilioenterik fistül görülmüştür. Perforasyon saptanan bir olguya sağ hemikolektomi uygulanmıştır.

Anahtar Kelimeler

Crohn hastalığı, inflamatuvar bağırsak hastalığı, multidedektör bilgisayarlı tomografi.

Kaynakça

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