Radiological diagnosis of inflammatory ulcerative diseases of the small bowel

AIMS To analyze the radiological features of the ul- cerative diseases of the small bowel. METHODS Thirty-five patients (20 men,15 women) with inflammatory ulcerative bowel diseases were stud- ied radiographically (barium meal and/or double con- trast study),including:11 cases of tuberculosis,13 Crohn disease,7 bowel Behcet disease,2 simple ulcer and 2 ischemic bowel disease. Diagnosis was estab- lished pathologically in 33 cases and by clinical obser- vation after therapy in 2 cases. RESULTS The lesions were located in ileum,in 9 of 11 cases of TB;in 10 of 13 cases of Crohn disease;in 5 of 7 cases of bowel Behcet disease;in 1 of 2 cases of simple ulcer and in 2 cases of ischemic bowel disease. Ulceration was always present with variable appearances. Longitudinal ulcers,and fissures were noted in Crohn disease only. There were 5 cases of large and deep ulcer and 3 occurred in bowel Behcet disease,10 of 13 cases of superficial and irregular ul- cers were tuberculous,2 cases of transverse ulcer were also tuberculous. CONCLUSIONS The morphologic appearances of the ulcer,surrounding mucosal alterations and bowel deformation were the basis for the radiologic diagnosis. Correct diagnosis was dependent on optimal X-ray ex- amination technique and proper interpretation of the morphologic changes.