Abdo: Small bowel

Playlist contributed by: Dr Annabelle Skelley

Small Bowel Masses (Malignant): 

  • Distal ileum: lymphoma, carcinoid 
  • Duodenum/jejunum: adenocarcinoma -> obstruction/apple-core 
  • Non-enhancing -> lymphoma (also rarely obstructs) 
  • Desmoplastic mesenteric reaction = carcinoid (not necessarily mass like), also adenocarcinoma
  • Malignant GIST -> large, heterogeneous (necrosis, haemorrhage) - calcs uncommon
  • Haematogenous metastases: melanoma, lung, breast, colon Ca, embryonal cell carcinoma of testes 
  • Peritoneal seeding metastases: ovarian, pancreas, colon Ca, gastric Ca 
  • Multiple lesions: polyposis syndromes, metastases, lymphoma, lymphoid hyperplasia & Kaposi sarcoma 

Benign Bowel Masses:

  • Benign GIST: smaller, homogeneous to muscle 
  • Lipoma: isointense to muscle (can cause obstruction/intussusception) 
  • Haemangioma: solitary submucosal projecting into lumen, jejunum -> look for calcified phlebolith 
  • Nodular lymphoid hyperplasia
  • Adenoma: polyp/filling defect

Terminal Ileitis:

  • Inflammatory (Crohn's, backwash ileitis from UC)
  • Infectious: Yersinia, Salmonella typhi, TB
  • Arthitides: ankylosing spondylitis, reactive arthritis 
  • Vascular: ischaemia, vasculitides (SLE, HSP) 
  • Radiation enteritis
  • Malignancy 
  • Drug-related: NSAID enteropathy 
  • Infiltrative: amyloidosis, sarcoidosis, eosinophilic gastroenteritis, systemic mastocytosis 
  • Endometriosis
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rID: 18826
Visibility: public

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