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Transient angioedema of small bowel secondary to intravenous iodinated contrast medium.

Kulkarni KN, Hegde RG, Balani A, Joshi AR - Indian J Radiol Imaging (2014)

Bottom Line: We report the clinical details and imaging findings of a case of transient angioedema of the small bowel following intravenous administration of non-ionic iodinated contrast material in a 17 year old female with no predisposing risk factors.Findings included long segment, symmetric, circumferential, low-density, bowel wall thickening involving the duodenum, jejunum, and most of the ileum on computed tomography scan obtained at 7 min following intravenous contrast material injection.This entity is self-limiting with a favourable clinical outcome and requires no specific treatment but only aggressive clinical monitoring.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Mumbai, Maharashtra, India.

ABSTRACT
We report the clinical details and imaging findings of a case of transient angioedema of the small bowel following intravenous administration of non-ionic iodinated contrast material in a 17 year old female with no predisposing risk factors. Findings included long segment, symmetric, circumferential, low-density, bowel wall thickening involving the duodenum, jejunum, and most of the ileum on computed tomography scan obtained at 7 min following intravenous contrast material injection. This entity is self-limiting with a favourable clinical outcome and requires no specific treatment but only aggressive clinical monitoring.

No MeSH data available.


Related in: MedlinePlus

Axial (A) and parasagittal (B) images from CT of the abdomen and pelvis reveal long segment, circumferential, small bowel wall thickening. Note the pattern of the bowel wall with the low-density submucosa (outlined by black arrowheads) surrounded by enhancing mucosa and serosa giving a “target” appearance
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Figure 1: Axial (A) and parasagittal (B) images from CT of the abdomen and pelvis reveal long segment, circumferential, small bowel wall thickening. Note the pattern of the bowel wall with the low-density submucosa (outlined by black arrowheads) surrounded by enhancing mucosa and serosa giving a “target” appearance

Mentions: CT of the abdomen and pelvis was performed on a 64-detector row CT scanner (Brilliance CT; Philips, Best, the Netherlands) after giving 1.0 L of 20% diluted non-ionic iodinated oral contrast material (300 mg I/ml, Ultravist; Bayer Pharma AG, Berlin, Germany) 1 h before and 300 ml of the same just before the scan. After obtaining a non-enhanced CT, 70 ml of intravenous non-ionic iodinated contrast material (300 mg I/ml, Ultravist; Bayer Pharma AG, Berlin, Germany) was administered at a rate of 3 ml/sec via an automated pressure injector. CT scans of the abdomen and pelvis were obtained at 1 and 7 min following the administration of intravenous contrast material. CT revealed long segment, symmetric, circumferential, low-density, bowel wall thickening involving the duodenum, jejunum, and most of the ileum on the delayed scan obtained at 7 min following intravenous contrast material injection. The presence of low-density thickened submucosa sandwiched between the enhancing mucosa and serosa gave an appearance referred to as the “target sign” [Figure 1]. There was no such thickening of the bowel wall on the non-enhanced scan or on the scan obtained at 1 min post injection [Figure 2]. There was neither free fluid nor mesenteric fat stranding. The mesenteric vessels were of normal caliber with no filling defects. The colon appeared normal in all the scans.


Transient angioedema of small bowel secondary to intravenous iodinated contrast medium.

Kulkarni KN, Hegde RG, Balani A, Joshi AR - Indian J Radiol Imaging (2014)

Axial (A) and parasagittal (B) images from CT of the abdomen and pelvis reveal long segment, circumferential, small bowel wall thickening. Note the pattern of the bowel wall with the low-density submucosa (outlined by black arrowheads) surrounded by enhancing mucosa and serosa giving a “target” appearance
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4126148&req=5

Figure 1: Axial (A) and parasagittal (B) images from CT of the abdomen and pelvis reveal long segment, circumferential, small bowel wall thickening. Note the pattern of the bowel wall with the low-density submucosa (outlined by black arrowheads) surrounded by enhancing mucosa and serosa giving a “target” appearance
Mentions: CT of the abdomen and pelvis was performed on a 64-detector row CT scanner (Brilliance CT; Philips, Best, the Netherlands) after giving 1.0 L of 20% diluted non-ionic iodinated oral contrast material (300 mg I/ml, Ultravist; Bayer Pharma AG, Berlin, Germany) 1 h before and 300 ml of the same just before the scan. After obtaining a non-enhanced CT, 70 ml of intravenous non-ionic iodinated contrast material (300 mg I/ml, Ultravist; Bayer Pharma AG, Berlin, Germany) was administered at a rate of 3 ml/sec via an automated pressure injector. CT scans of the abdomen and pelvis were obtained at 1 and 7 min following the administration of intravenous contrast material. CT revealed long segment, symmetric, circumferential, low-density, bowel wall thickening involving the duodenum, jejunum, and most of the ileum on the delayed scan obtained at 7 min following intravenous contrast material injection. The presence of low-density thickened submucosa sandwiched between the enhancing mucosa and serosa gave an appearance referred to as the “target sign” [Figure 1]. There was no such thickening of the bowel wall on the non-enhanced scan or on the scan obtained at 1 min post injection [Figure 2]. There was neither free fluid nor mesenteric fat stranding. The mesenteric vessels were of normal caliber with no filling defects. The colon appeared normal in all the scans.

Bottom Line: We report the clinical details and imaging findings of a case of transient angioedema of the small bowel following intravenous administration of non-ionic iodinated contrast material in a 17 year old female with no predisposing risk factors.Findings included long segment, symmetric, circumferential, low-density, bowel wall thickening involving the duodenum, jejunum, and most of the ileum on computed tomography scan obtained at 7 min following intravenous contrast material injection.This entity is self-limiting with a favourable clinical outcome and requires no specific treatment but only aggressive clinical monitoring.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Mumbai, Maharashtra, India.

ABSTRACT
We report the clinical details and imaging findings of a case of transient angioedema of the small bowel following intravenous administration of non-ionic iodinated contrast material in a 17 year old female with no predisposing risk factors. Findings included long segment, symmetric, circumferential, low-density, bowel wall thickening involving the duodenum, jejunum, and most of the ileum on computed tomography scan obtained at 7 min following intravenous contrast material injection. This entity is self-limiting with a favourable clinical outcome and requires no specific treatment but only aggressive clinical monitoring.

No MeSH data available.


Related in: MedlinePlus