Index

NoTE: Page numbers in italics refer to illustrations; page numbers followed by the letter t refer to tables.

Abdominal tuberculosis. See and differential diagnosis, 401 Amyloidosis, 260, 366--367 Mycobacterium tuberculosis and enteroclysis, 399, 399, 400, 401 Anastomosis, 510, 511 Abetalipoproteinemia, 363, 363-364 and eosinphilic gastroenteritis, 361 Anatomy Abscesses fish tapeworm and, 296 of bowel folds, 7, 8, 9, 9, 10, 527, 528t and anisakiasis, 293 hemangiomas, 386 of bowel wall, 5, 5, 6-9, 527 in appendix, 61, 61, 286, 307 overview of, 395-396 of the enteric nervous system, 11 in Crohn's disease, 263, 281-282, 281-283 precancerous conditions, 396--97 loop distribution and, 4-5, 5 interventional radiologic therapy and, and selective IgA deficiency, 309 of mesentery, 3-4 217-218 sonography and, 143, 144, 400-401 and sonography, 126--127 and jejunal diverticulosis, 353, 353t treatment and prognosis of, 401-402 of superior mesenteric artery, 10, 11 percutaneous drainage of, 217-218 Adenomas, 377, 383, 386 of villi, 9, 10, 11, 527 sonography and, 129, 129, 132 Adenomatous polyps, 142 Anclyostomiasis, 292-293 tuba-ovarian, 307 Adenopathy, in Whipple's disease, CT Angiodysplasia, 187 Absorption. See also and, 162 Angiodysplasias/vascular ectasias, 456, of carbohydrates, 19, 19-20 Adenosarcomas, and Meckel's 457 of lipids, 20-21, 21 diverticulum (MD), 235 Angiography, 187 motility and, 22-24 Adults acute small bowel hemorrhage, of protein, 20, 20, 21 celiac disease, 333, 334 diagnosis of, 203-204, 204t, 205-206, of trace elements and vitamins, 21 Crohn's disease, 259 207 Absorptive functions, differentiation of Cronkhite-Canada syndrome, 394 adenocarcinomas, 399, 400, 401 embryology, 13, 14 , 371, 372 and angiodysplasias/vascular ectasias, extrinsic nervous system, 13, 13, 14 ileal dysgenesis, 253 456 intrinsic nervous system, 13, 13 inflammatory fibroid polyps (IFP), 390 and angiographic localization, 204, 205 Absorptive physiology, 14, 16, 17-18, 1St, intestinal rotation, 244, 246 and carcinoid tumors, 412, 413 19 intussusception, 379 and celiac axis compression syndrome, Acanthosis, and abetalipoproteinemia, 363 leiomyoma, 383 455-456 Acquired immune deficiency syndrome lipomas, 385 and chronic gastrointestinal bleeding, (AIDS) lymphangiectasia, 358 213-215 and abdominal tuberculosis, 297 malignant tumors, 379 complications of, 210-211 and AIDS-defining illnesses, 315t Meckel's diverticulum (MD), 234, 239 diagnostic versus therapeutic, 203, 204t and computed tomography (CT), 161 omentum, 126 and hemangiomas, 389,457 definition of, 316 , 356 leiomyoma and, 383, 385 and, 16 Waldenstrom's macroglobulinea, 370 leiomyosarcomas and, 424 epidemiology, 316 Zollinger-Ellison syndrome (ZES), 364 and mesenteric ischemia, 448, 454 and histoplasmosis, 304-305 Adventitia, 9 and mesenteric varices, 457 and HIV enteritis, 314-315 Adynamic ileus, 62, 134 and neurogenic tumors, 389 immunology of, 32 Afferent loop syndrome small bowel hemorrhage management, and Kaposi's sarcoma, 316, 323-324 after gastric surgery, 507-509, 509 209,210,211,212,213 lymphomas and, 161, 316, 324-326 and barium contrast studies, 508, 509 and tumors, 382, 385 and opportunistic infections, 316-323, and computed tomography (CT), 508, and vasopressin, 212-213 317-323 509 and visceral ischemia, 215, 216, 217 overview, 314-315, 316t and scintigraphy, 196, 508 and Zollinger-Ellison syndrome (ZES), and strongyloidiasis, 293 and sonography, 508 365 Actinomycosis, 131 AIDS. See Acquired immune deficiency Anisakiasis, 293, 294 Acute arterial embolism, 441 syndrome Ann Arbor staging system, of non- Acute arterial thrombosis, 440-441 Air Hodgkin's lymphoma, 414 Acute intestinal ischemia, 440-449, 443- as a contrast agent, 41, 156 Annular lesions, differential diagnosis and, 447,449 and magnetic resonance imaging (MRI), 534-537, 537t, 538-542, 541t Acyclovir, and post-transplant 172 Anorexia lymphoproliferative disorder (PTLD), Air double contrast enteroclysis, 118-121, and Cronkhite-Canada syndrome, 394 328 120-122, 120t and malabsorption, 332 Adenocarcinomas Air-fluid levels, in small bowel, 52-53, 61 and tumors, 379 and angiography, 215, 399, 400, 400, 401 Albendazole, and microsporidia, 323 Anticholinergics, 83 annular, 535 Allergic granulomatosis angiitis, 450 Anticoagulant therapy, and small bowel and bacterial overgrowth syndrome, 349 Allogenic transplantation, graft-versus-host hemorrhage, 137, 161 carcinoma and, 348 disease, 312 Aperistalsis, 136 and celiac disease, 343 Alpha chains, and immunoproliferative Appendix and computed tomography (CT), 157, small intestinal disease (IPSID), 311, abscesses in, 61, 61, 307, 545 397, 399, 400, 401 378 and actinomycosis, 131 and Crohn's disease, 260, 286, 536 Amino acids, 14 computed tomography (CT) and, 162 567 568 • Index

Appendix (Contd.) myobacterium tuberculosis, 298, 299, hemangiomas, 386 and Crohn's disease, 260, 286 320-321,322 hookworm and, 292-293 sonography and, 162 neurogenic tumors, 389-390, 390 inflammatory fibroid polyps (IFP), 390 and torsion of the omentum, 132 non-Hodgkin's lymphoma, 415, 416, 417, leiomyoma, 383 Apudomas, 402 418, 422, 422 lipomas, 385-386 Arterial occlusion, 440 paraduodenal , 248 Meckel's diverticulum (MD), 234 Arterial thrombosis, 440 radiation enteritis, 452-453, 454-455, neurogenic tumors, 142, 389-390, 390 Arteriography, superior mesenteric, 389 454-456 tumors, 379 Arteriovenous malformations (AVMs), 224 roundworm, 292, 292 Blind loop syndrome, 512 Arthritis salmomellosis, 303 Blind pouch syndrome, 512, 512 and Crohn's disease, 260 shigellosis, 304 Blood-pool labeling, 188-189 and Whipple's disease, 358 short bowel syndrome, 356 Blue rubber bleb nevus syndrome, 457 Ascariasis, 291-292, 292 strongyloidiasis, 294, 295 Bone marrow transplant. See Graft-versus- Ascites, 128-129, 164 systemic mastocytosis, 360, 361 host disease and carcinoids, 403 systemic sclerosis, 350-351 Bowel folds and eosinphilic gastroenteritis, 362 tapeworm, 295 anatomy of, 7, 8, 9, 9, 10 exudative, 128 transomental hernias, 253 differential diagnosis and, 554-562, 555, and mesenteric ischemia, 446 and transplantation, 522, 522, 523 556t, 558t, 561-562, 563t and metastatic disease, 425 tropical sprue, 348 of ileum, 8, 9, 9 and myobacterium tuberculosis, 298, 301 tumors, 377,382 jejunal, 7, 8, 9, 9 Atopy, and eosinphilic gastroenteritis, 361 yersiniosis, 302, 302 Bowel loops. See Loops Atrophic gastritis, and common variable Zollinger-Ellison syndrome (ZES), 365, Bowel wall immunodeficiency syndrome (CVI), 365 anatomy of, 5, 5, 6--7, 8-9, 527 310 Barium sulfate thickening, 5-6, 6, 136, 157-161, 262-263, Auerbach's autonomic nerve plexus, 8, 14 for "dedicated" small bowel meal, 43 461 Autocrine communication, 16, 16 and magnetic resonance imaging (MRI), Bradykinin, 507 Azithromycin, and cryptosporidiosis in 171-172 Breath hydrogen analysis, 332 children, 317 and other barium-based methods, 43 Broncospasm, and carcinoid syndrome, 403 for small bowel meal, 42 Brunner's glands, 383, 529 Bacillary angiomatosis, 323 transit acceleration, 82-84 Burkitt's lymphoma, 160, 324, 325, 419, Bacterial enteritis Barrett's , and Zollinger-Ellison 420 campylobacter, 303, 303, 304 syndrome (ZES), 365 Bypass enteritis, 513 mycobacterium tuberculosis, 297-301 B cells salmonellosis, 303 and acquired immune deficiency Calcifications shigellosis, 304 syndrome (AIDS), 315, 324-325 carcinoid syndrome, 403 yersiniosis, 302-303 and common variable immunodeficiency mesenteric mass, 130 Bacterial overgrowth syndrome, 332, syndrome CCVI), 309-310 myobacterium tuberculosis, 301 348-349, 349, 349t, 350 and immunoproliferative small intestinal schistosomiasis, 297 Barium contrast studies disease (IPSID), 311 Calcium, 21 adenomas,383,386 and post-transplant lymphoproliferative Campylobacter, 303, 303, 304 afferent loop syndrome, 508, 509 disorder (PTLD), 328 Capillary hemangiomas, 388, 456 amyloidosis, 366-367 Beh<;et's syndrome, 450 Carbohydrates, digestion and absorption anisakiasis, 293, 294 Bezoars, 75, 149 of, 19-20, 20 blind loop syndrome, 512 Bilbao-Dotter tube, 42-43 Carcinoid tumors, 531 campylobacter, 303, 303 Bile salt deconjugation, and giardiasis, 296 angiography and, 214, 215, 412, 413 celiac disease, 336-339, 338, 338-342 Bilomas, 129, 129 clinicopathologic aspects of, 402-403 continent reservoir, 517-518 Biopsy,340-343,555,561 computed tomography (CT) and, 403, Crohn' s disease, 271 and AIDS-related lymphomas, 325 405-412, 410, 412 cryptosporidiosis, 316--317, 317 and amyloidosis, 366, 367 and enteroclysis, 403, 405, 407 cytomegalovirus (CMV), 317-318, 318, and celiac disease, 340-343 magnetic resonance imaging (MRI) and, 319 distal duodenal, 335 403,408, 409,409 diabetes, 367 endoscopic mucosal, 333 and Meckel's diverticulum (MD), 235 eosinphilic gastroenteritis, 361, 361, 362 and giardiasis, 296 metasticized, 534 giardiasis, 296, 297 and histoplasmosis, 304 overview, 377, 402 graft-versus-host disease, 313, 313, 314 and HIV enteritis, 315 and scintigraphy, 410 hemangiomas, 389, 457 and immunoproliferative small intestinal small bowel follow-through and, 403, ileal dysgenesis, 254 disease (IPSID), 312, 312 404 ileoanal pouch, 519-520 and jejunal diverticulosis, 355 sonography and, 144, 146, 214, 215 ileostomy, 516 and lactase deficiency, 369 Carcinoma, 187 inadvertent gastroilectomy, 510, 510 and liposarcoma, 132 celiac disease and, 348 inflammatory fibroid polyps (IFP), 390, and lymphangiectasia, 369 and common variable immunodeficiency 391 and myobacterium tuberculosis, 298 syndrome CCVI), 310 intersigmoid hernias, 253 and non-Hodgkin's lymphoma, 422 and Crohn' s disease, 283 intestinal rotation, 243-244 nonvascular interventional radiology, Castleman's disease, 325 intramural hemorrhage, 458 215, 217 Catheters. See Intubation isoporiasis, 317 small bowel, combined with enteroclysis, Cavernous hemangiomas, 388, 456 jejunal diverticulosis, 354, 354 118 Cavitary mass, differential diagnosis and, jejunogastric intussusception, 509, 510 and South American blastomycosis, 304 537,542t,543-544 , 513 and strongyloidiasis, 294, 295 Cecal volvulus, 243 leiomyoma, 383, 384, 384, 385 and Whipple's disease, 358 Celiac artery, 439 leiomyosarcomas, 424, 424 Biphasic enteroclysis, 111, 114 Celiac axis compression syndrome, lipomas, 386, 387 Biscodyl (Dulcolax), 82, 96 455-456 mesenteric ischemia, 442, 443-444, Bleeding. See also Hemorrhage Celiac disease 444-445 adenomas, 383 and adenocarcinomas, 396 metastatic disease, 426 amyloidosis, 366 after gastric surgery, 507 midgut duplications, 230, 231 carcinoma, 348 barium radiology and, 336--339, 338, myobacterium avium intracellular (MAl) Crohn' s disease, 260 338-342 infection, 318-319, 320 and enteroclysis, 116, 118 clinical diagnosis of, 334-335 Index • 569

complications of, 344, 344-348, 346-348 CT enteroclysis, 263, 264 Contrast agents definition of, 333-334 cytomegalovirus, 318, 318-319 and computed tomography (CT), enteroclysis and endoscopic biopsy, enlarged lymph nodes, 344 154-156, 156, 157 340-343 enteropathy associated T-celllymphoma and magnetic resonance imaging (MRI), epidemiology, 334 (EATCL), 345-348,347 168-172, 169-172 mucosa in, 335, 335 familial polyposis coli, 394-395 Contrast ileograms, 519-520 nonspecific radiologic findings in, giardiasis, 296 Corticosteroids 335-336,336 graft-versus-host disease, 314, 315 and Crohn' s disease, 260 other associations of, 343 hemangiomas, 457 and myobacterium tuberculosis, 298 and selective IgA deficiency, 309, 309 hyposplenism, 344 Cowden's disease, 319, 393 sonography and, 148 ileoanal pouch, 520, 520 Creeping , and Crohn's disease, 261 variants of, 343 ileostomy, 516, 517 Crohn' s colitis, 259 Cell-mediated immunity, 30 inflammation, 307 Crohn's disease, 187, 260 acquired, 32, 33, 34 intestinal rotation, 245-246 and abdominal tuberculosis, 297 innate, 31-32 intramural hemorrhage, 458 and adenocarcinomas, 286, 396, 536 Ceruletide, 42, 83 jejunal diverticulosis, 354, 354 and appendiceal abcesses, 286 Chest radiograph, 48, 50 jejunoileal bypass, 513-514 clinical considerations of, 259-260 Children Kaposi's sarcoma, 323-324 complications of, 277-283, 281-283 celiac disease and, 334 leiomyoma, 383, 384, 385 and computed tomography (CT), 157, and Crohn's disease, 260 leiomyosarcomas, 424 160, 162, 163, 163, 262, 263, 264 and cryptosporidiosis, 317 lipomas, 386, 387 and CT (ESCT), 117 enteroclysis and, 116 lymphangiectasia, 369 and diffuse jejunoileitus, 277, 277 foreign bodies in, 76-77 Meckel's diverticulum (MD), 237, 239 disease activity of, 283-284, 284-285 and ileal dysgenesis, 253 mesenteric, 3-4, 4 enteroclysis and, 261-262 and intestinal rotation, 243-244, 244 mesenteric ischemia, 445-446, 445-447, and enterolithiasis, 75-76 and lactase deficiency, 368 448,455 and, 261-262 and Meckel's diverticulum (MD), 234, mesenteric varices, 457 etiology of, 259 239 metastatic disease, 425, 428, 430 history of, 42 and nodular lymphoid hyperplasia midgut duplications, 230, 231 and ileal reservoirs, 517 (NLH), 310, 311 myobacterium avium intracellular (MAD infectious ileitis, 284-285 omentum and, 126 infection, 319, 320 inflammatory polyps in, 534 roundworms and, 291-292 myobacterium tuberculosis, 298, ischemia, 286 and short bowel syndrome, 356 300-301,320-321,322 and loop ileostomy, 514 and yersiniosis, 302 neurogenic tumors, 390, 390 lymphoma, 286 , 41 non-Hodgkin's lymphoma, 415, 416, 417, and magnetic resonance imaging (MRI), Cholecystokinin, 42, 83 418 177, 178, 265 Chronic intestinal pseudo-obstruction paraduodenal hernias, 250-251 malabsorption and, 369 (CIP), 25t, 26, 26t, 349-350 post-transplant lymphoproliferative and metastatic disease, 286, 427 Chronic mesenteric ischemia, 453-455 disorder (PTLD), 328 National Cooperative Crohn's Disease Churg-Strauss syndrome, 450 principles of interpretation, 156-161, 162, Study, 81 Chylous cysts, 129 163, 164-165 pathology of, 260-261 Closed-loop obstruction, 135 "pseudomasses," 154 and plain film radiography, 261 Clostridium difticile, 304 radiation enteritis, 452, 453 prevalence of, 259 Cobalamin, 21 roundworm, 292, 292 progression and remission in, 275 Cobblestoning, and Crohn's disease, 267, salmonellosis, 303 and radiation enteropathy, 286 268 schistosomiasis, 297 radiologic findings and, 265-274, Codeine, 83 shigellosis, 304 266-276 Coffee bean configuration, 68 small bowel injury, in blunt abdominal recurrence,275-277 Colchicine, and lactase deficiency, 369 trauma, 459, 460, 461 scintigraphy and, 196-197, 264-265 Cole, Lewis Gregory, 41 spiral CT, 263 and secondary mesenteritis, 132 Collagen systemic mastocytosis, 361 and selective IgA deficiency, 309 and Crohn' s disease, 271 technique, 153-154, 154 and short bowel syndrome, 356 and systemic sclerosis, 350 transplantation, 522, 523, 524 and small bowel fistulography, 87 Collagenous sprue, 343 tumors, 381, 381, 382 and small bowel obstruction, 61, 62 Colloids, 188 value of, 153 and sonography, 138-139, 138-139, 264, , 187 Whipple's disease, 358 264 Common variable immunodeficiency yersiniosis, 303 strictures in, 536-537 syndrome (CVI), 309-310, 311 Zollinger-Ellison syndrome (ZES), 365, and tuberculosis, 286 Compression devices, 84 366 tumors in, 378 Computed tomography (CT) Congenital anomalies Crohn's Disease Activity Index, 260 adenocarcinomas, 157, 397, 397, 399, 400, in adults and children, 227 Cronkhite-Canada syndrome, 394 401 ileal dysgenesis, 253-254, 253-254 Cryptosporidiosis, 316-317, 317, 317 as adjunct to plain film radiography, of intestinal fixation, 246-253, 247-254 CT enteroclysis (CT-E), 43, 116-117, 119, 47 of intestinal rotation, 241-246, 242-246 263,264 afferent loop syndrome, 508, 509 Meckel's diverticulum (MD), 145, 147, CT(ESCT), 117, 119 AIDS-related lymphoma, 324 147 CT-Sellink, 117 amyloidosis, 367 midgut development, 227, 228 Culture of duodenal aspirates, 332 anastomosis, 511 midgut duplications, 229-232, 230, 231 Cutaneous flushing, and carcinoid angiodysplasias/vascular ectasias, 456 midgut rotation, 227-228, 229 syndrome, 403 bacillary angiomatosis, 323 omphalomesenteric duct, 232-441, Cyclosporine, and post-transplant carcinoid tumors, 403, 405-412, 410, 232-441 lymphoproliferative disorder (PTLD), 412 small bowel duplication, 145 328 carcinoma, 348 Congenital arteriovenous malformations, Cystic carcinoid, 130 celiac axis compression syndrome, 456 Cysticercosis, 296 455-456 Constrictive disease, and abdominal Cystic fibrosis, 150, 150, 371, 372 celiac disease, 338-339, 340 tuberculosis, 297 Cystic mesothelioma, 130 contrast agents for, 154-156, 156, 157 Continent ileostomy reservoir, 517-518, Cystic spindle cell tumor, 130 Crohn's disease, 262, 263 518 Cystic teratoma, 130 570 • Index

Cysts solitary polyp, 528-533, 530-534, 531t, advantages and disadvantages of, 95 chylous, 129 534t air double contrast, 118-121, 120-122, cystic tumors, 130-131 target lesions, 533, 535 120t duplication, 129, 145 tethering of folds, 542-543, 546 and amyloidosis, 367, 367 mesenteric, 129 thick, undulating, or nodular folds and and angiodysplasias/vascular ectasias, mesolethial, 129 mucosal nodularity, 554-562, 555, 556t, 456,457 pancreatic pseudocyst, 130 558t, 561-562, 563t biphasic, 111, 114 pseudocyst, 129 tubular bowel, 562, 563t, 564, 564 and blind pouch syndrome, 512, 512 Cytomegalovirus (CMV), 157 Whipple's disease, 358-359 and blood loss from tumors, 379 and AIDS, 317-318, 318-319 yersiniosis, 302-303 carcinoid tumors and, 403, 405, 407 and common variable immunodeficiency Digestion, 14, 16, 17-18, 18, 19 carcinoma and, 348 syndrome (CVI), 310 Digital subtraction angiography (DSA), and celiac disease, 345, 346 and graft-versus-host disease, 313-314 204-205,205 celiac disease and, 338-339, 339, 340-343, Dilatation, 218, 219, 335 341,342 Decompression tube, and enteroclysis, Diphenoxylate (Lomotil), 83 and common variable immunodeficiency 112-113, 115-117 Diphyllobothrium latum, 296 syndrome (CVI), 310, 311 Demerol, 96 Diverticulitis, and Meckel's diverticulum Crohn's disease and, 261-262, 262, 271 Dermatitis herpetiformis, 343 (MD), 234 digital fluoroscopy for, 95, 118, 98-119 Diabetes, 343, 367 Double contrast and enteropathy associated T-cell Diarrhea enteroclysis, 103-104, 106-113, 107-113 lymphoma (EATCL), 345-348,347 abetalipoproteinemia, 363 and small bowel follow-through, 88, 89, enteroscopy and, 224--225, 225 AIDS-related, 16, 315 90,90 first use of, 41 amyloidosis, 366 Double halo sign, 403, 446 and ileostomy, 516 bacterial overgrowth syndrome, 349 Drainage procedures, 217-218 and immunoproliferative small intestinal blind loop syndrome, 512 Duodenal ulcers, and Zollinger-Ellison disease (IPSID), 312 blind pouch syndrome, 512 syndrome (ZES), 364 and inflammation, 307 campylobacter, 303 Duodenoscopy, and myobacterium avium and jejunal diverticulosis, 353 carcinoid syndrome, 403 intracellular (MAl) infection, 318 lumen diameter and, 5, 5-6 chronic mesenteric ischemia, 453-454 and lymphangiectasia, 369 common variable immunodeficiency celiac disease, 336, 335-336 and Meckel's diverticulum (MD), 237, syndrome (CVI), 310 neoplastic disease, 209 237,239,240 Crohn's disease, 259 obstruction, 241, 243 mesenteric small bowel, 528, 528t, 529 Cronkhite-Canada syndrome, 394 pancreatico-duodenal arcade aneurysms, and metastatic disease, 425 cryptosporidiosis, 317 209 and myobacterium avium intracellular diabetes, 367 pancreatitis, 209, 210, 211 (MAl) infection, 318-319, 320 eosinphilic gastroenteritis, 361, 362 peptic ulceration, 208-209 and paraduodenal hernias, 248-249 giardiasis, 296 Duplication cysts, 129, 145 and small bowel follow-through, 81-82 ileostomy, 516 D-Xylose absorption-excretion test, 332 tumors and, 380, 380 immunoproliferative small intestinal and Waldenstrom' s macroglobulinea, disease (IPSID), 311 Ectopic ovarian dermoid, 130 370, 372 inadvertent gastroilectomy, 510 Embolism, acute arterial, 441 and Whipple's disease, 358, 359 ischemia, 441-442 Embolization, 208, 413 Enterocutaneous fistulae, 218 jejunoileal bypass, 513 Embryology, 13, 14 Enteroglucagen, 507 and metastatic disease, 427 Endocrine communication, 15-16, 16 Entero-H, 84 microsporidia, 323 Endocrine disorders Enteroliths, and Meckel's diverticulum myobacterium tuberculosis, 298 diabetes, 367 (MD), 236 salmomellosis, 303 hypoparathyroidism, 367 Enteropathy associated T-celllymphoma secretory, 24 hypothyroidism, 368 (EATCL), and celiac disease, 345-348, short bowel syndrome, 355, 512 Endocrine neoplasia syndrome type I, 378 347 strongyloidiasis, 294 Endometrial implants, and metastatic Enteroplasty, 507 systemic mastocytosis, 360 disease, 427 Enteroscopy systemic sclerosis, 350 Endometriosis, 148, 543 and angiodysplasias/vascular ectasias, tumors, 378, 379 456 Waldenstrom's macroglobulinea, 370 and amyloidosis, 367 and Crohn's disease, 261 yersiniosis, 302 and celiac disease, 335 enteroclysis and, 224-225, 225 Zollinger-Ellison syndrome (ZES), 364 and Crohn's disease, 261 ileoscopy, 224 Diazepam, 96 endoscopic biopsy, 340-343, 358 indications for, 224--225, 225 Dicyclomine, and magnetic resonance and enteroclysis, 113-114 intraoperative, 224 imaging (MRI), 167 and lymphangiectasia, 369 push type, 223 Differential diagnosis and systemic mastocytosis, 360 risks with, 225 adenocarcinomas, 401 and Whipple's disease, 358-359 sonde type, 224 annular lesions, 534--537, 537t, 538-542, Enemas, and small bowel follow-through, and tumors, 377, 382 541t 82 Enterostomy, 514 cavitary mass, 537, 542t, 543-544 Enterectomy, and small bowel Enterotomy, 507 celiac disease, 335 anastomosis, 510-511, 511 Entrobar, 84 dilated lumen, normal fold thickness, Enteric duplication, 129 Eosinophilia 550-551, 550-553, 550t, 552t, 553, 555 Enteric nervous system and eosinphilic gastroenteritis, 361-363, eosinphilic gastroenteritis, 361-362 anatomy of, 11 361-362 extrinsic mass effect and tethering, 543, extrinsic, and differentiation of hookworm and, 293 545,547-550,547t absorptive function, 13, 13, 14 Eosinophilic granulomatous polyps, 390 metastatic disease, 426-427 intrinsic, and differentiation of Epithelial barrier, immunity and, 29-30, 30 midgut duplications, 230, 231 absorptive function, 13, 13 Epithelium, 6, 6 multiple polypoid lesions, 533, 535t, Enteritis Epstein-Barr virus (EBV), 324, 327-328 536 parasitic diseases and, 291 Erect abdominal radiograph, in plain film myobacterium tuberculosis, 298, 300 radiation, 160,450-453,453-455 radiography, 48, 50 non-Hodgkin's lymphoma, 422 Enteroclysis Erythema nodosum, and Crohn' s disease, separation of bowel loops, 537, 539, 542, and abetalipoproteinemia, 363-364 260 545-546' 545t and adenocarcinomas, 399, 399, 400, 401 Exoenteric lesion, 537 Index • 571

Extrinsic mass effect and tethering, Gastroenteritis, 139 and omphalocele, 241, 242 differential diagnosis and, 543, 545, Gastroesophageal reflux, and systemic and paraileostomy herniation, 516, 516 547-550, 547t sclerosis, 350 strangulated, 59, 67 Gastrografin, 42, 83, 154 and strangulation, 135 Fabry's disease, 351, 355 Gastrointestinal peptides, 16, 17t Herpes virus, and common variable False-negative radiographic examination, Gastrointestinal stromal tumor (GIST), 533 immunodeficiency syndrome (CVI), 377 Gastrointestinal ulcers, and Zollinger- 310 Familial adenomatous polyposis, 514 Ellison syndrome (ZES), 364 Herring worm disease, 293 and adenomas, 383 Gastromark, and magnetic resonance Heterotopic gastric mucosa, 391 Familial hypercholesterolemia, 514 imaging (MRl), 171 High resolution sonography (HRS), 125 Familial Mediterranean fever, and Gastroschisis, 241 Histoplasmosis, 304-305 amyloidosis, 366 Giardasis, and abetalipoproteinemia, 364 Hodgkin's disease (HD), 422, 423 Familial polyposis coli, 394, 394-39 Giardia lamblia, 296 Hookworm, 292-293 carcinoma, 394 Giardiasis, 296, 297, 310 H2 receptor blockers, and Zollinger-Ellison desmoid tumors, 394 Glucagon, 189,516 syndrome (ZES), 364 Gardner's syndrome, 394 and magnetic resonance imaging (MRl), Human immunodeficiency virus (HIV) lymphoid hyperplasia, 394 167, 170 enteritis, 315-316 medulloblastoma, 394 Graft-versus-host disease and opportunistic infections, 316 small bowel adenomas, 394 acute, 312 Humoral immunity, 30, 31, 32 Turcot syndrome (glioblastoma), 394 and allogenic bone transplantation, 312 Hydrogen breath test Fat wrapping, Crohn's disease and, 261 and autologeous bone transplantation, and bacterial overgrowth syndrome, 349 Feathering, 528 312 and lactase deficiency, 369 Fecal fat test, and malabsorption, 332 barium studies and, 313, 313, 314, 314 Hydronephrosis, in Crohn's disease, 260, Fentanyl, 96 chronic, 313 263 Ferric ammonium citrate (FAC), and and computed tomography (CT), 314, Hyoscine butylbromide, and magnetic magnetic resonance imaging (MRI), 315 resonance imaging (MRI), 167 169 grading of, 312 Hyoscine-N-butyl bromide (Buscopan), 83 Fibrofatty proliferation indications for, 312-314, 313-314 Hyperlipidemia, and jejunoileal bypass, in Crohn's disease, 261, 263 induction protocol and, 312 513 differential diagnosis and, 539 subacute, 312 Hyperoxaluria, and short bowel syndrome, Fibroid inflammatory polyps, 142, 142 treatment of, 314 357 Fibrosarcomas, and leiomyosarcomas, 424 Granulomas Hypoalbuminemia, 293 Fibrosis and abdominal tuberculosis, 297 and abetalipoproteinemia, 364 and Crohn's disease, 271, 274, 275 and Crohn's disease, 261 and lymphangiectasia, 369 and schistosomiasis, 296-297 Gut-associated lymphoid tissue, 32-33 Hypobetalipoproteinemia, and Fish tapeworm, 296 lymphoid aggregates, 33, 35, 35 abetalipoproteinemia, 363 Fistulae nonaggregated lymphoid tissue, 35, Hypogammaglobulinemia, 419 and Crohn's disease, 279-281, 279-281 35-36 Hypogammaglobulinemic sprue, and and jejunal diverticulosis, 353, 353t Gut-associated lymphoid tissue (GALT), common variable immunodeficiency and myobacterium tuberculosis, 298 and non-Hodgkin's lymphoma, 414 syndrome (CVI), 310 and short bowel syndrome, 356, 356 Hypomotility, and celiac disease, 335 Fistulography, 87-88 Hamartomas, 383, 534 Hyposplenism, and celiac disease, 344 Fixation, anomalies of, 246-253, 247-254 Hamartomatous polyposis syndromes Hypotension, and systemic mastocytosis, Fluoroscopy, digital, for enteroclysis, 95-96 Cowden's disease, 319, 393 360 catheters and infusions, 96-97 juvenile polyposis, 393 intubation,96-102,98-106 Peutz-Jeghers syndrome, 391-392, IgA with methylcellulose, 108-104, 106-108, 391-393 and acquired immune deficiency 110, 111-113 Ruvalcaba-Myre-Smith syndrome, 393 syndrome (AIDS), 315 Focal ischemia, 449 Hamartomatous polyps, 142 celiac disease and, 309, 309, 334, 343 Folic acid, and jejunal diverticulosis, 352 Headache, and systemic mastocytosis, 360 and common variable immunodeficiency Folic polyglutamate, 21 Heart disease, and carcinoid syndrome, syndrome (CVI), 309-310 Foramen of Winslow, 251-252, 252 403 and giardiasis, 296 Foreign bodies Helical CT, 446, 447 and lymphangiectasia, 369 and Meckel's diverticulum (MD), 234 Hemangiomas, 386-389, 388, 389, 456-457 IgG and plain film radiography, 76-77 Hematoma, small bowel, 137-138 celiac disease and, 334 Fungal infections Hemoperitoneum, 461 and common variable immunodeficiency histoplasmosis, 304-305 Hemorrhage syndrome (CVI), 309-310 South American blastomycosis, 304 acute gastrointestinal, 187-191,203-204, Crohn' s disease and, 334 204t and lymphangiectasia, 369 Gadolinium solutions, and magnetic angiography and, 203-215, 204t, 205-207, IgM resonance imaging (MRI), 169, 170, 210-217 and common variable immunodeficiency 265 blunt abdominal trauma and, 458 syndrome (CVI), 309-310 Gallstone ileus, 62, 64-65, 65, 66, 148 and Crohn' s disease, 260 and giardiasis, 296 Gallstones CT and, 161 and selective IgA deficiency, 309, 309 and Crohn's disease, 260, 261, 263 intramural, 458, 458, 459 Ileal dysgenesis, 253-254, 253-254 and short bowel syndrome, 357 and jejunal diverticulosis, 353, 353t Ileal reservoirs, 517-521 Ganglioneuromas, 390 and midgut duplications, 230 Ilecolic artery, 10, 11 Gardner's syndrome, 131 sonography and, 137-138, 138 Ileoanal pouch, 518-521, 519-521 and adenomas, 383 Henoch-Schonlein Purpura, 450 Ileocecal tuberculosis. See Myobacterium and familial polyposis coli, 394 Henoch-Schonlein syndrome (HSS), 138 tuberculosis Gas Hepatic fibrosis, and schistosomiasis, 297 Ileocolitis, acute, 140-141 and magnetic resonance imaging (MRl), Hepatocellular jaundice, 368 Ileoscopy, 224 172 Hernias, 507 Ileostomy, 514, 516, 516-517 patterns, 51-57, 54-60 congenital internal, 246-247, 251-253, Ileum Gastric metaplasia, 529, 531 247-254 angiography and, 209, 212 Gastric sarcoma, 378 and gastroschisis, 241 bowel folds of, 8, 9, 9, 338-339, 339- Gastrinomas, and Zollinger-Ellison of Littre, 234 340 syndrome (ZES), 364 and Meckel's diverticulum (MD), 234 terminal, 9, 9 572 • Index

Ileus entry into pylorus, 99, 102 Leiomyosarcomas, 160 adynamic, 62, 134 hiatus , 99, 101 and angiography, 424 plain film radiography, 54-58, 59-62, history of gastric surgery or upper GI and angiosarcomas, 424 64-65, 65, 66 problems, 102, 106 and barium contrast studies, 424, 424 Imaging techniques peroral, 97 and computed tomography (CT), 424 angiography and interventional problems of, 99, 100 and fibrosarcomas, 424 radiology, 203-226 sedation and, 95, 96 and liposarcomas, 424 barium and, 41--45 transgastric, 97-99, 98, 99 pathology of, 423 computed tomography (CT), 153-166 transnasal introduction of catheter, 97 and plain film radiography, 423-424 enteroclysis, 95-124 tube arrested at an unexpected level, symptoms of, 423 enteroscopy, 223-226 100,105 treatment of, 424 magnetic resonance imaging (MRI), tube buckled in esophagus, 99, 101 Leukemia, and X-linked 167-186 tube coiled in gastric fundus, antrum, or hypogammaglobulinemia, 309 plain film radiography, 47-80 duodenum, 99-100, 102, 103 Leukocyte labeling, 196, 264 scintigraphy, 187-202 Intubation studies, historical aspects of, Lipids, digestion and absorption of, 20-21, small bowel follow-through (SBFT), 41--42 21 81-94 Intussusception Lipomas, 131, 141-142, 142, 385-386, 387, sonography, 125-152 and celiac disease, 336, 336 398, 531 Immune deficiency diseases. See also hemangiomas, 388 Liposarcomas, and leiomyosarcomas, 424 Acquired immune deficiency and inflammatory fibroid polyps (IFP), Littre' s hernia, 234 syndrome (AIDS) 390 Loculated ascites, 128 common variable immunodeficiency jejunogastric, 509-510 Loops syndrome (CVI), 309-310, 311 leiomyoma and, 383 closed-loop obstruction, 135 and giardiasis, 296 lipomas and, 385 in Crohn' s disease, 263, 262 graft-versus-host disease, 312-314, and Meckel's diverticulum (MD), 234, distribution of, 4-5, 5 313-314 235 ileal, 4-5, 5 immunoproliferative and neurogenic tumors, 389 jejunal, 4-5, 5 disease (IPSID), 310-312, 312 sonography and, 147-150, 148, 149 length of, 3 and infections of the small intestine, and strangulation, 135 and loop ileostomy, 514 316-326, 317-327 and systemic sclerosis, 351 and metastatic disease, 425, 426 post-transplant lymphoproliferative and tumors, 379 and myobacterium tuberculosis, 301 disorder (PTLD), 327-328, 328 Iron, 21 separation of, 537, 539, 542, 545-546, 545t secondary,326-327 Ischemia, 160, 267, 286, 343 stepladder or hairpin, 58-59, 60 selective IgA deficiency, 309, 309 acute intestinal, 440--449, 443- 447 , 449 Lumen and solid organ transplantation chronic mesenteric, 453--455 diameter of, 5, 5-6 (immunosuppression), 327 focal, 449 differential diagnosis and, 550-551, X-linked hypogammaglobulinemia, 309 nonoclusive mesenteric, 441 550-553, 550t, 552t, 553, 555 Immunity and short bowel syndrome, 356, 357 Luminal communication, 16, 16 cell-mediated, 30-32, 33, 34 symptoms of, 441--442 Lymphadenopathies, 131, 315, 325 the epithelial barrier, 29-30, 30 Ischemic colitis, Crohn's disease and, 259 Lymphangiectasia, 369 gut-associated lymphoid tissue, 32-36, Isolated intestinal transplantation, 521 and abetalipoproteinemia, 364 35 Isoporiasis, 317 and Whipple's disease, 358 humoral, 30 Lymphangiomas, 129, 142, 143 and the integrated immune response, 36 Jejunal dyskinesia, 352, 354 Lymph nodes and strongyloidiasis, 294 Jejunogastric intussusception, 509-510, 510 cavitation of, 344, 344-345 Immunoproliferative small intestine Jejunoileal bypass, 512-514, 513 and celiac disease, 344 disease (IPSID), 310-312, 312, 419 Jejunoileitis, ulcerative, 537 and Whipple's disease, 358 Inadvertent gastroileostomy, 510, 510 , 514, 515 Lymphocytes, 30, 32 Infections, opportunistic, and AIDS, 316 Jejunum Lymphocytic colitis, and celiac disease, 343 Infectious enteritis, 160 angiography and, 209, 212 Lymphocytopenia, and lymphangiectasia, Infectious ileitis, and Crohn' s disease, bowel folds of, 7, 8, 8, 9, 9, 336-338, 369 284-285 337-339 Lymphoid aggregates, 33, 35, 35 Inflammation and jejunal diverticulosis, 351-355, 353- Lymphoid follicles, 7 inflammatory diseases, 25-26, 138-140, 355, 353t Lymphoid hyperplasia, and common 141,173,297-304,304-307 loop distribution and, 4, 5, 5 variable immunodeficiency syndrome perienteric, 140-141, 141 mosaic pattern in celiac disease, 339, (CVI), 310 Inflammatory bowel disease, and 341 Lymphoid tissue ileostomy, 514 Juvenile polyposis, 187, 393 and common variable immunodeficiency Inflammatory fibroid polyps (IFP), 142, 142 syndrome (CVI), 310, 311 Infusions, for enteroclysis, 96-97 Kaposi's sarcoma, 316, 323-324 gut-associated, 32-34, 35 Innate immunity, 31-32 and acquired immune deficiency nonaggregated, 35-36 Intercellular communication, 15 syndrome (AIDS), 316, 325 Lymphomas Interferon-alpha, 413 and bacillary angiomatosis, 323 and acquired immune deficiency Intersigmoid hernias, 253, 253 and target lesions, 533 syndrome (AIDS), 316, 324-326 Interspace spikes, 553 Kaposi's sarcoma-associated herpes virus and Crohn's disease, 267, 283, 286 Interventional radiology, nonvascular (KSHV), 323, 325 and lymphoid hyperplasia, 310 biopsy and, 215, 217 Kerckring's folds, 7, 9 mesenteric, 131 and drainage procedures, 218 Klippel-Trenaunay syndrome, 457 metasticized, 534 and percutaneous jejunostomy, 218 and nodular lymphoid hyperplasia Intestinal endometriosis, 148 Lactase deficiency, 368-369 (NLH), 310 Intramural hematoma, and small bowel Ladd's bands, 242 scintigraphy and, 187 injury, 461 Lamina propria, 6, 7, 9, 10 sonography and, 143, 144 Intramural hemorrhage, 458, 458, 459 Left lateral abdomen view, in plain film and X-linked hypogammaglobulinemia, Intubation radiography, 50-51, 56 309 catheter preparation, 97 Left lateral decubitus film, in plain film duodenojejunal flexure, 100, 104 radiography, 50 Macrocytic anemia, fish tapeworm and, and enteroclysis, 96 Leiomyomas, 187,214-215,383,384-385 296 Index • 573

Maculopapular rash, and acquired noncontiguous extention and lymphatic Mesothelial cyst, 129 immune deficiency syndrome (AIDS), spread,431,431--432 Metastatic disease 315 Malignant lymphomatous polyposis and barium contrast studies, 426 Magnetic resonance angiography (MRA), (MLP), 417, 419 from bronchogenic carcinoma, 429, 430 173-181 Mallory-Weis tear, 223 from carcinoma of the breast, 429-431, Magnetic resonance imaging (MRI) Malnutrition, roundworm and, 292 431 as adjunct to plain film radiography, 47 Malrotation and Crohn' s disease, 286 applications, with optional use of and inadvertent gastroileostomy, 510 and differential diagnosis, 426-427 contrast agents, 173, 173-178 midgut, with or without volvulus, 137 and malignant melanoma, 427-429 benefit of, 167, 173 Manganese chloride, and magnetic noncontiguous extension and lymphatic and carcinoid tumors, 403, 408, 409, 409 resonance imaging (MRI), 169, 170 spread,431,431-432 contrast agents, 168-172, 169-172 Mannitol, and magnetic resonance imaging sonography and, 143, 143, 426, 427 development of, 167 (MRI), 170 Metoclopramide, 42, 83, 96, 155, 271, 355 and enlarged lymph nodes, 344 Mantle cell lymphoma (MCL), 417 Microsporidia, 323 and hemangiomas, 457 Mastocytosis, and systemic sclerosis, Midazolam, 96 and intramural hemorrhage, 458 350-351, 351, 352 Midgut development, 227, 228 and Meckel's diverticulum (MD), 239 M cells, 29 Midgut duplications, 230-231, 230-232 mesenteric, 3, 4, 4 Meckel's diverticulum (MD), 145, 147, 147, Midgut ischemia, 343 and mesenteric ischemia, 442, 445--446, 531 Midgut malrotation with or without 448,455 angiography and, 214, 214 volvulus, 137 and mesenteric varices, 457 carcinoids and, 402 Midgut rotation MR angiographic (MRA) techniques, in children, 234, 241 within hernia, 227-228 173-177, 179-180, 179-181 computed tomography (CT) and, 237, stage of fixation, 228, 229 and myobacterium tuberculosis, 298, 301 239 stage of rentry, 228, 229 technique, 167-168 enteroclysis and, 237, 237 Morphine, 83, 96 tumors and, 381 heterotopic gastric mucosa and, 391 Mosaic pattern, and celiac disease, 339, 341 and Zollinger-Ellison syndrome (ZES), history of, 43 Motor disorders, 25t, 26-27, 26t 365 ileal dysgenesis and, 254 Motor function, of the small intestine, Malabsorption leiomyoma and, 383 21-24, 22, 23 abetalipoproteinemia and, 363, 363-364 plain film radiography and, 75-76 MR angiography (MRA), 173-177, 179-180, after gastric surgery, 507 scintigraphy and, 187, 191-192, 194 179-181, 455 amyloidosis and, 366-367, 367, 368 small bowel follow-through (SBFT) and, Mucosa, 527 bacterial overgrowth syndrome and, 237, 237, 238 of bowel wall, anatomy of, 5, 5, 6-7 348-349,349,3491,350 sonography and, 145, 147, 147, 237, 239 changes, in celiac disease, 335, 335-336 blind loop syndrome and, 512 treatment and management of, 239, 241 and malabsorption, 333 celiac disease and, 333-348, 348 Mediterranean lymphoma Mucosal nodularity, 554-562, 555, 556t, chronic intestinal pseudo-obstruction immunoproliferative small intestinal 558t, 561-562, 563t and, 349-350 disease (IPSID) and, 311, 312, 312, 378, Multiple phlebactasia, 388-389 classification of, 331-332, 332t 419 Muscularis, of bowel wall, anatomy of, 8-9 Crohn's disease and, 260, 369 non-Hodgkin's disease and, 419 Muscularis mucosae, 6, 7 Cronkhite-Canada syndrome and, 394 Meglumine diatrizoate (Gastrografin), 83, Muscularis propria, 8 cryptosporidiosis and, 317 154, 292 Mycobacterium tuberculosis, 297-301 cystic fibrosis and, 371, 372 Meissner's nerve plexus, 8, 14, 355 Myenteric nerve plexus, 8, 14 diagnosis of, 332-333, 333 Melanoma, metastatic, 533-534 Myobacterium avium intracellular (MAl) endocrine disorders, 367-368 Mesalamine, and Crohn's disease, 260 infection, 131, 162 enteroclysis and, 114, 116 Mesenchymal tumors, benign, and AIDS and, 318-3220, 320, 321 eosinphilic gastroenteritis and, 361, Meckel's diverticulum (MD), 235 and Whipple's disease, 358 361-363,362 Mesenteric adenitis, 139-140 Myobacterium tuberculosis, 162, 259, 298, giardiasis and, 296 Mesenteric border, 3 320-322,322 graft-versus-host disease and, 312 pseudodiverticula, 355 Myoepithelial hamartoma, 390-391 inadvertent gastroileostomy and, 510 ulcers, 269, 270, 271 Myxedema ileus, and hypothyroidism, jejunal diverticulosis and, 351-355, 353, Mesenteric cyst, 129 368 353t, 354, 355 Mesenteric desmoid tumor, 131 lactase deficiency and, 368-369 Mesenteric disease, and computed National Cooperative Crohn's Disease lymphangiectasia and, 369 tomography (CT), 161-164, 162, 163 Study, 81, 261 maldigestion and, 368 Mesenteric fibromatosis, 395 Nausea physiology of, 24-25, 24t Mesenteric fluid, and small bowel injury, and strongyloidiasis, 294 radiology and, 333 461 tapeworm and, 295 roundworm and, 292 Mesenteric ischemia, nonocclusive, from tumors, 379 short bowel syndrome and, 355,355-357, 441-442,444--446,449 Neomycin, and lactase deficiency, 369 356 Mesenteric lymphadenopathy, 324 Neoplastic disease, 160, 209. See also systemic mastocytosis and, 359-361, 360 Mesenteric lymph nodes Tumors systemic sclerosis and, 350-351, 351, 352 cavitation of, 344, 344-345 Neostigmine, 42 tropical sprue and, 348 computed tomography (CT) and, 162 Neurocrine communication, 15-16, 16 Waldenstr8m's macroglobulinea and, Mesenteric lymphoma, 131, 132 Neuroendocrine communication, 16, 16 370,370,372 Mesenteric nodes, in Crohn's disease, 263 Neurolemomas, 389-390 Whipple's disease and, 357-359, 358, 359 Mesenteric panniculitis, 131-132 Nodularity Zollinger-Ellison syndrome (ZES) and, Mesenteric varices, 457, 458 and celiac disease, 335, 336 364-366,365,366 Mesenteric vascular disease, plain film mucosal, 554-562, 555, 556t, 558t, Malassimilation, 332 radiography and, 71, 72 561-562, 563t Maldigestion, 24-25, 24t, 331, 368 Mesenteric vascular occlusion, and Nodular lymphoid hyperplasia (NLH), Malignancies, secondary. See also strangulation, 135 419 Metastatic disease; Tumors Mesenteric venous thrombosis, 441 and common variable immunodeficiency hematogenous dissemination, 427--431, Mesentery syndrome (CVI), 310, 311 428-431 anatomy of, 3-4, 4, 126-127, 127 and selective IgA deficiency, 309, 309 intraperitoneal seeding of metastases, computed tomography of, 3, 4 Nodular polyp pattern, in Crohn's disease, 425-427,426-427 cystic lesions of, 129-131, 130, 131 267,269 574 • Index

Non-Hodgkin's lymphoma, 143, 162, Peptic ulcers, 208-209 and leiomyosarcomas, 423--424 535-536,537 and Meckel's diverticulum (MD), 234 level of small bowel obstruction, 57, 58, classification and staging, 414--415 and midgut duplications, 230 59, 60 clinical features, 414--415 roundworm and, 292 and magnetic resonance imaging (MRI), and differential diagnosis, 422 Peptides, 14, 16, 17t 47 differential diagnosis and, 422, 537, 542t, Percutaneous jejunostomy, 218 and Meckel's diverticulum (MD), 543-544 Percutaneous transluminal angioplasty, 235-236 and improved staging, 422 455 and mesenteric ischemia, 442 and needle biopsy, 422 Perflubron, and magnetic resonance mesenteric vascular disease and, 71, 72 overview, 414 imaging (MRI), 172 and midgut duplications, 230, 231 radiology of, 415, 416--422, 417, 419, Perfluorocarbon, and magnetic resonance normal intestinal gas pattern, 52, 52-53, 422--423 imaging (MRI), 172 53 treatment and prognosis of, 422--423 Perforation and paracecal hernias, 253 Nonocclusive mesenteric ischemia, and amyloidosis, 366 and paraduodenal hernias, 248 441--442,444--446,449 and anisakiasis, 293 pneumatosis cystoides intestinalis, 73-75, Nonpancreatic pseudocyst, 129 blunt abdominal trauma and, 458, 460 74 Nonsteroidal antiinflammatory drugs and celiac disease, 345, 346 pneumoperitoneum secondary to small (NSAIDs), 537 and Crohn's disease, 260, 282-283 bowel perforation, 72-73, 73 and Meckel's diverticulum (MD), 234 in postoperative period, 71-72 Obesity and plain film radiography, 62, 72-73 pseudo-obstruction, 350, 351 and hypertrophy of mesenteric fat, 305 Perienteric disease, and computed radiation enteritis and, 452 and inadvertent gastroilectomy, 510 tomography (CT), 161, 161 relevance of, 47 and jejunoileal bypass, 512 Periodic acid-Schiff (P AS)-positive roundworm and, 292, 292 and separated bowel loops, 537, 539 macrophages, 357 and salmomellosis, 303 Obstruction. See Small bowel obstruction Peristalsis, 22, 22 and severity of obstruction, 65-66 Obstructive jaundice, 368 and jejunal diverticulosis, 354 and strangulating obstruction, 66--67, Octreotide, 16, 367, 413 and sonography, 133, 147 67--69, 67-70, 71 Oil emulsions and systemic sclerosis, 351 and systemic sclerosis, 350, 351 and computed tomography (CT), 155 Peritoneal carcinomatosis (PC), 144, 146, and transplantation, 522 and magnetic resonance imaging (MRI), 147, 165 tumor calcification and, 380 170-171 Peritoneal disease tumors and, 380, 380 Omentum and computed tomography (CT), 164, Plicae circulares, 527 anatomy of, 126, 127 164-165 Pneumatosis, and celiac disease, 343 cystic lesions of, 129-131, 130, 131 and MRI, 173, 174 Pneumatosis cystoides intestinalis, and and omental "cakes," 165, 403 and plain film radiography, 68, 69 plain film radiography, 73-75, 74 and peritoneal carcinomatosis (PC), 144, , abdominal wall and, 126, 126 Pneumatosis intestinalis, 513 146 Peritonitis Pneumoduodenography, 41 spontaneous segmental necrosis or and celiac disease, 345, 346 Pneumoperitoneum torsion of, 132-133, 133 roundworm and, 292 and celiac disease, 343 Omeprazole, and Zollinger-Ellison tuberculosis, 301 and Crohn's disease, 261 syndrome (ZES), 364 Pernicious anemia, and common variable and jejunal diverticulosis, 353, 353t Omphalocele, 241, 242, 254 immunodeficiency syndrome (CVI), secondary to small bowel perforation, Omphalomesenteric duct anomalies 310 and plain film radiography, 72-73, 73 Meckel's diverticulum, 232-241, 233-241 Peroral pneumocolon, and small bowel and small bowel injury, 461 types and development, 232, 232 follow-through, 85, 90, 90 and sonography, 129, 130 Opportunistic infections. See Infections, Peutz-Jeghers syndrome, 391-392, 397, 534 and systemic sclerosis, 351 opportunistic Peyer's patch, 7, 7-8, 33, 301 Pneumatosis, and small bowel injury, 461 Oral Magnetic Particles, and MRI, 171 Phleboliths, 457 Pneumatosis cystoides, and systemic Organ transplantation Phlegmon, in Crohn' s disease, 263 sclerosis, 351 (immunosuppression), 327 Phospholipids, 20-21 Polyarteritis nodosa, 449--450 Osler-Weber-Rendu disease, 389 Physiology Polyps Osteomyelitis, in Crohn's disease, 263 and differentiation of absorptive and Crohn's disease, 267-268, 269, function, 13, 14 269-270 Palisading, and metastatic disease, 425, 427 digestion and absorption, 19-21, 20, 21 differential diagnosis, 533, 535t, 536, Pancreatic achlyia, 368 and integration of function, 15-16, 16, 530-534, 531 t, 534t Pancreatico-duodenal arcade aneurysms, 17t fibroepithelial, 531 209 motor function, 21-24, 22, 23 and histoplasmosis, 304 Pancreatic pseudocyst, 130 principles of digestive and absorptive inflammatory, confused with adenomas, Pancreatitis, 209, 210, 211 physiology, 14, 16, 17-18, 18, 19 383 Panniculitis, 131-132 Picket fence sign, 442, 458, 553 and metastatic disease, 428, 428 Paracecal hernias, 252-253, 253 Pinkyprints sign, 442, 553 and schistosomiasis, 296-297 Paracoccidioidomycosis, 304 Plain film radiography Postgastrectomy syndrome, 507 Paracrine communication, 15-16, 16 acute abdominal series, 48-51, 49-51 Postgastrectomy transit disorders, 196 Paraduodenal hernias, 247-251, 247-251 and anastomosis, 511 Postsurgical small bowel Paragangliomas, 378 Crohn's disease and, 261 after gastric surgery, 507-510, 509, 510 Parasitic diseases distribution of small bowel gas in enterectomy and small bowel enteritis caused by parasites, 291-293, obstruction, 54-56, 53-55, 57 anastomosis, 510-511, 511, 512-514, 294--295,296,297 enterolithiasis, 75-76, 76 512,513 and geographic location, 291 essentials of interpretation, 51-52 enterostomy, 514, 515-517 Pareital peritoneum (PT), 126 and foramen of Winslow hernias, 248 ileal reservoirs, 517-521, 518-521 Pathophysiology foreign bodies in small bowel, 76, 76, 77 overview, 507, 508 inflammatory diseases, 25-26 and hemangiomas, 389, 457 small bowel transplantation, 521-524, malabsorption, 24-25, 24t and interobserver variations, 53 522-524 maldigestion, 24-25, 24t intestinal patterns, 54--55, 57-58, 58--65, Post-transplant lymphoproliferative motor disorders, 25t, 26-27, 26t 60-62, 65, 66 disorder (PTLD), 327-328, 328, secretory diarrhea, 24 and intestinal rotation, 243 523-524 Penicillin, and Whipple's disease, 359 and jejunal diverticulosis, 353, 353 Program on the Surgical Control of the Pentetreotide scintigraphy, 410 and jejunoileal bypass, 513 Hyperlipidemias (POSCH), 514 Index • 575

Protein Sclerosing cholangitis, in Crohn's disease, metastatic disease and, 425 and Cronkhite-Canada syndrome, 394 263,263 midgut duplications and, 230 digestion and absorption of, 20, 20 Sclerosis, and hemangiomas, 388 myobacterium tuberculosis and, 298, and eosinphilic gastroenteritis, 361 Sedation, and enteroclysis, 95, 96 301 Provocation technique, 207 Selective IgA deficiency, 309, 309 neurogenic tumors and, 389 Pruritis, and systemic mastocytosis, 360 Sentinel clot sign, 461 plain film radiography and, 47 Pseudocyst, 129 _ Seritonin, and carcinoids, 402 simple, 134-135, 135 Pseudomyxoma peritonei, 130, 164, Seroconversion syndrome, and acquired strangulation, 66-{59, 67-70, 71, 71, 164--165 immune deficiency syndrome (AIDS), 135-137, 136, 137 Pseudo-obstruction 315 tumors and, 378, 379 and amyloidosis, 366 Seroma, 129, 129 Small bowel perforation, and plain film biopsy and, 349-350 Serosa, of bowel wall, anatomy of, 8-9 radiography, 72-73 and celiac disease, 343 Serotonin, 507 Small bowel transit time (SBTT), and and jejunal diverticulosis, 352 Serous ascites, 128 scintigraphy, 194-196 radiology and, 350 Shigellosis, 304 Small bowel transplantation. See Pseudopolyps, and Crohn's disease, 267, Short bowel syndrome, 355, 355-357, 356, Transplantation 268 512 Small intestinal transit Pseudotumor, 67 Single-contrast enteroclysis scintigraphy and, 194-195 Pseudo Whipple's, 358 Nolan's technique, 103 small bowel follow-through (SBFT) and, Purines, 14 Sellink's technique, 102-103 82-83 Push enteroscopy, 223 Single positron emission computed Somatostatin receptor scintigraphy, 410 tomography (SPECT), use with Sonde enteroscopy, 224 Radiation damage, and metastatic disease, scintigraphy, 410 Sonogram, as adjunct to plain film 426 Sjogren's syndrome, and celiac disease, 343 radiography, 47 Radiation enteropathy, 450-453, 453-455 Small bowel Sonography bowel wall thickening and, 160 anatomy of, 127, 128 abnormalities, 128-133, 129-133 Crohn' s disease and, 286 folds of, 7, 8, 9, 9 and afferent loop syndrome, 508 Radiation ileitis, 267 foreign bodies in, 76-77 anatomy, 126-128, 127 Radiology. See also specific modalities length of, 3 and anisakiasis, 293 CT enteroclysis (CT-E), 43 Small bowel dilatation, 133-134, 134 celiac disease and, 148 historical aspects of, 41-45 Small bowel duplication, 145 computed tomography (CT) and, 125 Radionuclide tracers, 188 Small bowel enema. See Enteroclysis congenital disorders, 145, 147, 147 Rappaport classification, of non-Hodgkin's Small bowel follow-through (SBFT) Crohn's disease and, 138, 138-139, 139, lymphoma, 414 adenocarcinomas and, 397 264,264 Raynaud's phenomenon, and systemic amyloidosis and, 367, 368 and hyposplenism, 344 sclerosis, 350 carcinoid tumors and, 403, 404 infections and, 139-141, 140, 141 Reflux esophagitis, and Zollinger-Ellison Crohn's disease and, 261-262 and intestinal rotation, 245-246 syndrome (ZES), 365 Cronkhite-Canada syndrome and, 394 intussuception, 147-150, 148, 149 Refractory sprue, 343 enteroclysis and, 81-82 jejunoileal bypass and, 513 Retained gastric antrum, scintigraphy and, enteropathy associated T-celllymphoma Meckel's diverticulum (MD) and, 237, 194 (EATCL) and, 345-348,347 239 Rheumatoid vasculitis, 450 fluoroscopic, 82-85, 85, 86 mesenteric, 3, 4 Rifabutin, 318 foramen of Winslow hernias and, 252 mesenteric folds and, 3, 4 Rotation, anomalies of, 241-246, 242-246 immunoproliferative small intestinal mesenteric ischemia and, 448, 449, Roundworm, 148-150, 149, 291-292 disease (IPSID) and, 311-312 454-455 Roux stasis syndrome, and scintigraphy, limitations and indications of, 91 metastatic disease and, 143, 143, 426, 427 196 lymphangiectasia and, 369 myobacterium tuberculosis and, 301 Ruvalcaba-Myre-Smith syndrome, 393 Meckel's diverticulum (MD) and, 237, omphalocele and, 241 237,238 postoperative seroma and, 307, 307 modifications of the fluoroscopic, 85, sandwich pattern of lymphoma and, 41':1, Sacroileitis, in Crohn's disease, 260, 263 87-88,88,89,90-91 420 Salmonellosis, 303 paraduodenal hernias and, 249-250 small bowel dilatation and, 133-134, Sandostatin, 413 post-transplant lymphoproliferative 134-137 Sandwich pattern, of lymphoma, 419, 420 disorder (PTLD) and, 328, 328 small bowel hematoma or hemorrhage Sarcomas, 131, 235 tumors and, 38(}-381 and, 137-138, 138 Schistosomiasis, 296--297 weaknesses of, 81 small bowel pathologies and, 133 Scintigraphy Whipple's disease and, 358 technique for, 125, 126 acute gastrointestinal hemorrhage and, Small bowel injury, in blunt abdominal tumors and, 141-145, 142-147, 381 187-191, 189-191 trauma,458-461,459-461 and Zollinger-Ellison syndrome (ZES), afferent loop syndrome and, 196, 508 Small bowel manometry (SBM), and 365 amyloidosis and, 367 scintigraphy, 195 South American blastomycosis, 304 carcinoid tumors and, 197-198, 198-199, Small bowel meal (SBM), 528, 529 Splenomegaly, and common variable 410 celiac disease and, 348 immunodeficiency syndrome (CVI), Crohn's disease and, 196--197, 264--265 dedicated, 43 310 leiomyoma and, 383 history of, 42 Stack of coins sign, 442, 458, 551, 552 lymphangiectasia and, 369 Small bowel obstruction Stamm technique, 514 Meckel's diverticulum (MD) and, adenomas and, 383 Stenoses, 121 191-194, 192t, 193, 195-196, 239 closed-loop, 135, 136 Steroids, and eosinphilic gastroenteritis, mesenteric varices and, 457 Crohn's disease and, 277-279, 278 362 midgut duplications and, 23(}-231 differential diagnosis and, 550 Sterols, 20-21 non-Hodgkin's lymphoma and, 419 familial polyposis coli and, 394 Strangulation, 135 postgastrectomy transit disorders and, gas patterns in, 53-57, 54-60 and plain film radiography, 66--71, 67-71 196 hemangiomas and, 386, 388-389 and sonography, 135-137, 137 retained gastric antrum and, 194 intestinal rotation and, 241 Streptomycin, and Whipple's disease, 359 small intestinal transit and, 194-195 leiomyoma and, 383 Strictures tumors and, 382 level of, 57-58, 58-{50 and bacterial overgrowth syndrome, 349, Zollinger-Ellison syndrome (ZES) and, lipomas and, 385 349 365 Meckel's diverticulum (MD) and, 234 and histoplasmosis, 304 576 • Index

String sign, and Crohn's disease, 265, 271, Tryptophan, and carcinoids, 402 Henoch-SchOnlein Purpura, 450 274 Tuberculosis, computed tomography (CT) polyarteritis nodosa, 449-450 Stromal, 143, 145 and, 157, 162 rheumatoid, 450 Stromal tumor, 131, 160 Tuberculosis enteritis. See Myobacterium systemic lupus erythematosus, 450 Strongyloidiasis, 293-294, 295 tuberculosis Villous atrophy, and cryptosporidiosis, 317 Submucosa, of bowel wall, anatomy of, 7, Tuberculosis ileocolitis, 41, 42 Villus(i) 7-8 Tumors anatomy of, 9, 10, 11, 527 Submucosal nerve plexus, 8, 14 benign, 141-143,142-143,382-383, and Crohn's disease, 266, 266 Sulfasalazine, and Crohn's disease, 260 386-394,384-385,387-393 Viral hepatitis, and common variable Superior mesenteric arteriography, 389 clinical presentation, 378-379 immunodeficiency syndrome (CVI), Superior mesenteric artery (SMA), 10-11, etiologic factors, 378 310 11, 439 imaging considerations, 379, 379-382, Visceral ischemia Superparamagnetic iron oxide (SPIO), and 380-382 acute mesenteric ischemia, 215, 216 magnetic resonance imaging (MRI), malignant, 142-145, 143-147, 395-402, chronic, 215, 216, 217 171 395t, 396t, 397-401 Visceral peritoneum (VT), 126 Supine anteroposterior radiograph, in Meckel's diverticulum (MD), 235 Vitamins, 21 plain film radiography, 48, 49 mesenteric, 131, 132 deficiencies of, 349, 368 Symptoms. See specific symptoms omental, 131, 132 vitamin B12, 296, 352, 512 Systemic lupus erythematosus, 450 overview of, 377, 377-378 vitamin E, and abetalipoproteinemia, 363 Systemic mastocytosis, 360, 359-361, 360 secondary malignancies and, 425-432, Volvulus Systemic sclerosis, 350-351, 351, 352 426-432 and jejunal diverticulosis, 353, 353t Turner's syndrome, 389 and Meckel's diverticulum (MD), 234 Taenia saginata, 294-296 midgut, 241 Taenia solium, 296 Ulcerative jejunoileitis, and celiac disease, and midgut duplications, 230 Tapeworm, 294-296 345,346 and strangulation, 135 Target lesions, 533 Ulceronodular polyp pattern, in Crohn's Vomiting differential diagnosis and, 533, 535 disease, 268, 270 and adenocarcinomas, 397 and metastatic disease, 428, 428 Ulcers tapeworm and, 295 Target sign, 446 and acquired immune deficiency from tumors, 379 T cells, 32, 34 syndrome (AIDS), 315 and yersiniosis, 302 and acquired immune deficiency and amyloidosis, 366 von Recklinghausen's disease, 378, 389-390 syndrome (AIDS), 314-315 and anisakiasis, 293 and common variable immunodeficiency apthous,260,261,267,268,269,270 Waldenstrom' s macroglobulinemia, syndrome (CVI), 309-310 in Crohn's disease, 260, 261, 267, 268, 366-367,370,370,372 and cytomegalovirus (CMV), 317-318 269-271 Water, as a contrast agent, 155-156 and graft-versus-host disease, 313, 314 and histoplasmosis, 304 Weight loss and lymphangiectasia, 369 and inflammatory fibroid polyps (IFP), and bacterial overgrowth syndrome, 349 Teratoma, 130 390 carcinoma and, 348 Tethering, differential diagnosis and, lipomas and, 385-386 and Crohn's disease, 259 542-543,543,545,546,547-550,547t and metastatic disease, 425 and eosinphilic gastroenteritis, 361 Tetracycline, and jejunal diverticulosis, 355 and salmomellosis, 303 and immunoproliferative small intestinal Thrombosis, arterial, 440 and yersiniosis, 302 disease (IPSID), 311 Thumbprints sign, 442, 553 and Zollinger-Ellison syndrome (ZES), and malabsorption, 332 Thyroid disease, and celiac disease, 343 364 and myobacterium tuberculosis, 298 Toothpick penetration, 149-150, 150 Ultrasound. See Sonography and strongyloidiasis, 294 Total parental nutrition (TPN), 521 Urachal cyst, 131 and tumors, 379 Trace elements and vitamins, digestion Urinary tract calculi, and Crohn's disease, Whipple's disease, 141, 357-359, 358, 359 and absorption of, 21 261, 263 and computed tomography (CT), 162 Transit, acceleration, 82-84 Uveitis, and Crohn's disease, 260 and myobacterium avium intracellular Transjugular intrahepatic portosystemic (MAl) infection, 318, 319 stent shunt (TIPSS), 213 , 507 Witzel technique, 514 Transluminal angioplasty, 455 Vasa recta, 10 Transomental hernias, 253, 254 Vascular disorders X-linked hypogammaglobulinemia, 309 Transoral jejunal biopsy, and lactase classification of, 439-450, 453-457, 458, deficiency, 369 461,453-455,458-461 Yersinia ileitis, and Crohn's disease, 266 Transplantation, 521-524, 522-524 Vascular malformations, 456-457, 457 Yersiniosis, 140-141, 141, 302-303 , 20-21 angiodysplasias/vascular ectasias, 456 Trimethoprim-sulfamethoxazole, and hemangiomas,456-457 Zollinger-Ellison syndrome (ZES), 364-366, Whipple's disease, 359 Vascular occlusions, and short bowel 365,366 Tropheryma whippelii, 357-358 syndrome, 356 Trophozoites, and giardiasis, 296 Vasculitis, 160, 187, 449, 450 Tropical sprue, 348 Beh<;et's syndrome, 450 Trypsin, 20 Churg-Strauss syndrome, 450