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Magnetic resonance enterography: the test of choice in diagnosing intestinal "zebras".

Kumar AS, Coralic J, Vegeler R, Kolli K, Liang J, Estep A, Chudzinski AP, McFadden JD - Case Rep Gastrointest Med (2015)

Bottom Line: At our institution magnetic resonance enterography (MRE) has become an increasingly reliable tool in the difficult-to-diagnose or difficult-to-monitor patient.In this retrospective case series, we discuss four patients with four rare intestinal disorders that were successfully diagnosed using MRE after failing to be diagnosed using more routine technologies, such as CT scans and flexible sigmoidoscopies.With the discussion of these four cases we demonstrate that MRE is a useful diagnostic modality in patients whose surveillance is difficult or to diagnose rare colorectal disease phenomena, colloquially referred to as "zebras."

View Article: PubMed Central - PubMed

Affiliation: Section of Colon and Rectal Surgery, Department of Surgery, MedStar Washington Hospital Center, Washington, DC 20010, USA ; Department of Surgery, MedStar Washington Hospital Center, Washington, DC 20010, USA.

ABSTRACT
Small bowel tumors and other rare intestinal disorders are often exceedingly difficult to identify. Even cutting-edge technologies, such as push enteroscopy and capsule endoscopy, can fail to determine the cause of a patient's symptoms. At our institution magnetic resonance enterography (MRE) has become an increasingly reliable tool in the difficult-to-diagnose or difficult-to-monitor patient. In this retrospective case series, we discuss four patients with four rare intestinal disorders that were successfully diagnosed using MRE after failing to be diagnosed using more routine technologies, such as CT scans and flexible sigmoidoscopies. With the discussion of these four cases we demonstrate that MRE is a useful diagnostic modality in patients whose surveillance is difficult or to diagnose rare colorectal disease phenomena, colloquially referred to as "zebras."

No MeSH data available.


Related in: MedlinePlus

Axial (a) and coronal (b) MRE images with a large intraluminal (Peutz-Jeghers) polyp visible (yellow arrows).
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fig5: Axial (a) and coronal (b) MRE images with a large intraluminal (Peutz-Jeghers) polyp visible (yellow arrows).

Mentions: The patient's semiannual enteroscopies and flexible sigmoidoscopies had not demonstrated any new polyps or other etiology for this new anemia. A capsule study was read as negative three months prior to when the MRE was done. The MRE was able to demonstrate at least seven small bowel polyps; the largest was measured at 25 mm while the smallest ones were less than 10 mm (Figure 5). The patient proceeded to laparotomy where four polyps were removed through two enterotomies in the proximal and midjejunum (Figure 6).


Magnetic resonance enterography: the test of choice in diagnosing intestinal "zebras".

Kumar AS, Coralic J, Vegeler R, Kolli K, Liang J, Estep A, Chudzinski AP, McFadden JD - Case Rep Gastrointest Med (2015)

Axial (a) and coronal (b) MRE images with a large intraluminal (Peutz-Jeghers) polyp visible (yellow arrows).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4321082&req=5

fig5: Axial (a) and coronal (b) MRE images with a large intraluminal (Peutz-Jeghers) polyp visible (yellow arrows).
Mentions: The patient's semiannual enteroscopies and flexible sigmoidoscopies had not demonstrated any new polyps or other etiology for this new anemia. A capsule study was read as negative three months prior to when the MRE was done. The MRE was able to demonstrate at least seven small bowel polyps; the largest was measured at 25 mm while the smallest ones were less than 10 mm (Figure 5). The patient proceeded to laparotomy where four polyps were removed through two enterotomies in the proximal and midjejunum (Figure 6).

Bottom Line: At our institution magnetic resonance enterography (MRE) has become an increasingly reliable tool in the difficult-to-diagnose or difficult-to-monitor patient.In this retrospective case series, we discuss four patients with four rare intestinal disorders that were successfully diagnosed using MRE after failing to be diagnosed using more routine technologies, such as CT scans and flexible sigmoidoscopies.With the discussion of these four cases we demonstrate that MRE is a useful diagnostic modality in patients whose surveillance is difficult or to diagnose rare colorectal disease phenomena, colloquially referred to as "zebras."

View Article: PubMed Central - PubMed

Affiliation: Section of Colon and Rectal Surgery, Department of Surgery, MedStar Washington Hospital Center, Washington, DC 20010, USA ; Department of Surgery, MedStar Washington Hospital Center, Washington, DC 20010, USA.

ABSTRACT
Small bowel tumors and other rare intestinal disorders are often exceedingly difficult to identify. Even cutting-edge technologies, such as push enteroscopy and capsule endoscopy, can fail to determine the cause of a patient's symptoms. At our institution magnetic resonance enterography (MRE) has become an increasingly reliable tool in the difficult-to-diagnose or difficult-to-monitor patient. In this retrospective case series, we discuss four patients with four rare intestinal disorders that were successfully diagnosed using MRE after failing to be diagnosed using more routine technologies, such as CT scans and flexible sigmoidoscopies. With the discussion of these four cases we demonstrate that MRE is a useful diagnostic modality in patients whose surveillance is difficult or to diagnose rare colorectal disease phenomena, colloquially referred to as "zebras."

No MeSH data available.


Related in: MedlinePlus