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| Diagnostic value of CTE in inflammatory bowel disease from misjudged case |
| PENG Lai, HAN Yun-xue, GU Li-fang |
| Department of Radiology, Baoshan District, Shanghai Renhe Hospital, Shanghai 200431, China |
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Abstract Objective: To explore the diagnostic value of CT enterography(CTE) in inflammatory bowel disease(IBD). Methods: The imaging data and clinical data of 1 case of Crohn’s disease(CD) misdiagnosed as ulcerative colitis(UC) were analyzed retrospectively and combined with literature review. Results: A male patient of 57 years old suffered from the 2nd peak onset of UC, with frequent pus and blood stools and the lesion is limited to the colon, a common spot for UC. The first diagnosis of “perianal abscess” conforms to the clinical features of CD, and CTE showed that the lesion involved the intestinal wall of the whole layer, with segmental distribution, a large number of hyperplasia of blood vessels around bowel during the active period, which is consistent with the typical imaging of CD. Conclusions of the twice colonoscopy were “UC-severe total colonic type” and “IBD-CD?”. The patient was eventually diagnosed as a CD with pathological extraction of non-cheese granuloma. Conclusion: There are overlap in both clinical and imaging findings between UC and CD. When the lesion is confined to the colon, the observation of image details and the collection of medical history can help to identify. UC is occurring in the mucosa and submucosa, with general continuous distribution. CTE shows no characteristic changes, and colonoscopy and biopsy are the keys to the establishment of UC diagnosis. Segmental distribution, permeable wall inflammation and “Comb sign” are common CTE findings in CD. CTE is more valuable for CD diagnosis. The diagnosis of CD is preferred when perianal lesions are the first signs. The diagnosis of inflammatory bowel disease unclassified(IBDU) can be made when it is difficult to identify the two.
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Received: 22 January 2018
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