Gastrointestinal Imaging

Enteritis, drug toxicity

nonspecific ulceration of the small bowel, most frequently of the ileum caused by the long term use of nonsteroidal anti-inflammatory drugs (NSAID). Clinically, gastrointestinal blood loss or intermittent subobstruction complaints are noted.

The radiological features are demonstrated best by small bowel enema and may include long tapered strictures of the distal part of the small bowel similar to the strictures observed in Crohns disease or multiple circumferential diaphragma-like strictures. They are due to focal areas of transmural inflammation with submucosal fibrosis associated with disorganization of adjacent muscle fibres. The lesions may progress to produce marked stenosis of the lumen. Some chemotherapeutic drugs used for tumour treatment may also cause reversible toxic changes in the small bowel. Radiographic features include marked narrowing of the bowel lumen, with thickened and effaced folds, and wide separation of the loops.

ALB