Role of ultrasound in the evaluation of the ileocecal valve

Transcription

1 Role of ultrasound in the evaluation of the ileocecal valve Poster No.: C-1581 Congress: ECR 2010 Type: Scientific Exhibit Topic: GI Tract Authors: M. Mohammed, M. Hussain, U. Momin, S. Lakhtakia, N. D. Reddy; Hyderabad/IN Keywords: Ultrasound, Ileocecal valve, colonoscopy DOI: /ecr2010/C-1581 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 22

2 Purpose A study to show the ultrasonographic appearances of the ileocecal valve in normal and abnormal conditions. Methods and Materials The study consisted of two groups comprising 92 patients. Group A:We performed ultrasound in 50 cases which had been prepared for colonoscopy by mechanical bowel wash. We demonstrated an ileocecal valve having a slit/oval appearance. Group B: It comprised of 42 cases with varied pathologies, showing a diseased ileocecal valve. Graded sonographic compression technique was used, with an Aloka Prosound SSD-4000 machine using a convex probe of MHZ and a linear probe of 8-13 MHZ frequency. Images for this section: Page 2 of 22

3 Fig. 1: Normal slit like appearance of the ileocecal calve on ultrasound confirmed on colonoscopy Page 3 of 22

4 Fig. 2: Normal Oval appearance of the ileocecal valve on ultrasound confirmed on colonoscopy Page 4 of 22

5 Fig. 3: Colonoscopy showing a normal Ileocecal valve Page 5 of 22

6 Fig. 4: Colonoscopy showing a normal Ileocecal valve Page 6 of 22

7 Results The ileocecal valve was seen in 92 patients and in 50 cases the valve showed a normal slit appearance in 30 cases and oval in 20, which was confirmed to be normal on subsequent colonoscopy. In the remaining 42 patients, the valve showed an irregular, thickened, edematous and nodular appearance in Tuberculosis(12cases) and Crohn's disease(8), edematous valve with normal contour in Ileocolitis(4), smooth hypoechoic mass like appearance in Lymphoma(6), irregular shape with destruction of valve in Adenocarcinoma(6) {1}, edematous valve with a normal contour and a featureless ascending colon in Ulcerative colitis(6). These findings were confirmed by colonoscopic biopsy, and surgery in a few cases. Images for this section: Fig. 1: Ileocecal valve showing an irregular, thickened, edematous and nodular appearance in Crohn's disease confirmed on colonoscopic biopsy. Page 7 of 22

8 Fig. 2: Ileocecal valve showing an irregular, thickened, edematous and nodular appearance in Crohn's disease confirmed on colonoscopic biopsy. Page 8 of 22

9 Fig. 3: Ileocecal valve showing an irregular, thickened, edematous and nodular appearance in Crohn's disease confirmed on colonoscopic biopsy. Page 9 of 22

10 Fig. 4: Ileocecal valve showing an irregular, thickened, edematous and nodular appearance in Crohn's disease confirmed on colonoscopic biopsy. Page 10 of 22

11 Fig. 5: Ileocecal valve showing an irregular shape with destruction in Adenocarcinoma confirmed by colonoscopic biopsy and surgery Page 11 of 22

12 Fig. 6: Ileocecal valve showing an irregular shape with destruction in Adenocarcinoma, confirmed by colonoscopic biopsy and surgery Page 12 of 22

13 Fig. 7: Ileocecal valve showing an irregular, thickened, edematous and nodular appearance in Koch's disease confirmed on colonoscopic biopsy Page 13 of 22

14 Fig. 8: Ileocecal valve showing an irregular, thickened, edematous and nodular appearance in Koch's disease confirmed on colonoscopic biopsy Page 14 of 22

15 Fig. 9: Ileocecal edematous valve with normal contour in Ileocolitis confirmed on Colonoscopic biopsy. Page 15 of 22

16 Fig. 10: Ileocecal edematous valve with normal contour in Ileocolitis confirmed on Colonoscopic biopsy. Page 16 of 22

17 Fig. 11: Ileocecal valve showing an irregular shape with destruction in Adenocarcinoma, confirmed by colonoscopic biopsy and surgery Page 17 of 22

18 Fig. 12: Thickening of the ileocecal valve in Crohns confirmed by colonoscopic biopsy Page 18 of 22

19 Fig. 13: Thickening of the ileocecal valve in Koch's confirmed by colonoscopic biopsy Page 19 of 22

20 Fig. 14: Edematous valve with a normal contour and a featureless ascending colon in Ulcerative colitis confirmed by colonoscopic biopsy Page 20 of 22

21 Fig. 15: Ileocecal valve with a smooth hypoechoic mass like appearance in Lymphoma confirmed by colonoscopic biopsy. Page 21 of 22

22 Conclusion The abnormal ultrasound findings of the ileocecal valve in various diseases, correlated well with surgical and colonoscopic findings. Based on the above, it can be said that the usage of ultrasound is a novel way of looking at the ileocecal valve in both normal and abnormal conditions. References 1.Turk J Gastroenterol Dec;15(4): Adenocarcinoma of the ileocecal valve: report of a case. Yörük G, Aksöz K, Buyraç Z, Unsal B, Nazli O, Ekinci N. Department of Gastroenterology, Atatürk Teaching and Research Hospital, Izmir, Turkey. gyoruk@isbank.net.tr Personal Information M.K.Majaz Hussain DMRD, Department of Radiology, Asian Institute of Gastroenterology, Hyderabad, India. majaz75@yahoo.co.in Page 22 of 22