NSAID enteropathy: appearance at CT and MR enterography in the age of multi-modality imaging and treatment

Verfasser / Beitragende:
[Judson Frye, Stephanie Hansel, Steven Dolan, Jeff Fidler, Louis Song, John Barlow, Tom Smyrk, Kristina Flicek, Amy Hara, David Bruining, Joel Fletcher]
Ort, Verlag, Jahr:
2015
Enthalten in:
Abdominal Imaging, 40/5(2015-06-01), 1011-1025
Format:
Artikel (online)
ID: 605495211
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024 7 0 |a 10.1007/s00261-015-0367-2  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s00261-015-0367-2 
245 0 0 |a NSAID enteropathy: appearance at CT and MR enterography in the age of multi-modality imaging and treatment  |h [Elektronische Daten]  |c [Judson Frye, Stephanie Hansel, Steven Dolan, Jeff Fidler, Louis Song, John Barlow, Tom Smyrk, Kristina Flicek, Amy Hara, David Bruining, Joel Fletcher] 
520 3 |a CT and MR enterography and capsule endoscopy are increasingly used as routine diagnostic tests for patients with potential small bowel disorders and obscure gastrointestinal bleeding. Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used drugs that disrupt prostaglandin synthesis and result in a variety of localized complications within the small bowel ranging from ulcer formation to characteristic circumferential strictures, or diaphragms. NSAID enteropathy encompasses this spectrum of acute and chronic inflammatory sequelae, and is associated with typical findings at capsule endoscopy and surgery. Herein we review the typical clinical presentation of NSAID enteropathy, in addition to its endoscopic appearances, focusing on imaging findings at cross-sectional enterography. Multiple, short-segment strictures are the hallmarks of imaging diagnosis. Strictures may have minimal hyperenhancement or wall thickening, but these findings are typically symmetric and circumferential with respect to the bowel lumen. Multifocal Crohn's strictures, and occasionally radiation-induced strictures or adhesions, will mimic NSAID diaphragms. Multi-phase or multi-sequence imaging at CT and MR enterography increase diagnostic confidence in stricture presence. Strategies for subsequent workup and therapy after enterography are also discussed. Given the frequent use of NSAIDs and typical appearance of these strictures, knowledge of characteristic imaging findings can be particularly useful when evaluating patients with anemia and recurrent small bowel obstruction. 
540 |a Springer Science+Business Media New York, 2015 
690 7 |a Small bowel  |2 nationallicence 
690 7 |a CT enterography  |2 nationallicence 
690 7 |a Capsule endoscopy  |2 nationallicence 
690 7 |a NSAID enteropathy  |2 nationallicence 
700 1 |a Frye  |D Judson  |u Department of Radiology, Mayo Clinic Health System, La Crosse, WI, USA  |4 aut 
700 1 |a Hansel  |D Stephanie  |u Division of Gastroenterology, Mayo Clinic, Rochester, MN, USA  |4 aut 
700 1 |a Dolan  |D Steven  |u Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA  |4 aut 
700 1 |a Fidler  |D Jeff  |u Department of Radiology, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA  |4 aut 
700 1 |a Song  |D Louis  |u Division of Gastroenterology, Mayo Clinic, Rochester, MN, USA  |4 aut 
700 1 |a Barlow  |D John  |u Department of Radiology, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA  |4 aut 
700 1 |a Smyrk  |D Tom  |u Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, USA  |4 aut 
700 1 |a Flicek  |D Kristina  |u Department of Radiology, University of Arizona, Tucson, AZ, USA  |4 aut 
700 1 |a Hara  |D Amy  |u Department of Radiology, Mayo Clinic, Scottsdale, AZ, USA  |4 aut 
700 1 |a Bruining  |D David  |u Division of Gastroenterology, Mayo Clinic, Rochester, MN, USA  |4 aut 
700 1 |a Fletcher  |D Joel  |u Department of Radiology, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA  |4 aut 
773 0 |t Abdominal Imaging  |d Springer US; http://www.springer-ny.com  |g 40/5(2015-06-01), 1011-1025  |x 0942-8925  |q 40:5<1011  |1 2015  |2 40  |o 261 
856 4 0 |u https://doi.org/10.1007/s00261-015-0367-2  |q text/html  |z Onlinezugriff via DOI 
898 |a BK010053  |b XK010053  |c XK010000 
900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a review-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s00261-015-0367-2  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Frye  |D Judson  |u Department of Radiology, Mayo Clinic Health System, La Crosse, WI, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Hansel  |D Stephanie  |u Division of Gastroenterology, Mayo Clinic, Rochester, MN, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Dolan  |D Steven  |u Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Fidler  |D Jeff  |u Department of Radiology, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Song  |D Louis  |u Division of Gastroenterology, Mayo Clinic, Rochester, MN, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Barlow  |D John  |u Department of Radiology, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Smyrk  |D Tom  |u Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Flicek  |D Kristina  |u Department of Radiology, University of Arizona, Tucson, AZ, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Hara  |D Amy  |u Department of Radiology, Mayo Clinic, Scottsdale, AZ, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Bruining  |D David  |u Division of Gastroenterology, Mayo Clinic, Rochester, MN, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Fletcher  |D Joel  |u Department of Radiology, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Abdominal Imaging  |d Springer US; http://www.springer-ny.com  |g 40/5(2015-06-01), 1011-1025  |x 0942-8925  |q 40:5<1011  |1 2015  |2 40  |o 261