Radiological changes in Crohn's disease

Pathological changes of the intestinal wall largely determine the peculiarities of the x-ray picture in Crohn's disease. While the lesions are not continuous nature, are still areas normal mucosa. In addition, changes may not cover the entire circumference of the intestine, and distributed only on one side of the latter.
On Limbing (1960), x-ray study of patients with Crohn's disease are observed stenotic and destinationsin signs. The first of them typical for the early phases of the disease. Such patients in phase deployed clinical manifestations there are multiple changes of the colonic lumen. Due to the sharp wall thickening of the intestine radiologist determines the rigidity of the affected intestinal loops, and the narrowing of its gleam. Areas above changes are expanding. Mucosal edema and linear ulcers create a unique mosaic of small filling defects. A similar pattern is reminiscent of "the cobbled road". In hollows and cracks flows barium suspension, forming pockets that are directed from the lumen into the depths of the intestinal wall. This picture is a pathognomonic for Crohn's disease.
Over time, the mucous loses folding, the relief is smoothed, bowel takes the form of a tube. With the defeat of the end of the ileum often found "a symptom of strings", first described Kantor in 1934 (Fig. 45). There has been a sharp narrowing clearance end of the ileum, either due to an inflammatory swelling, or the development of fibrous tissue. Can be internal fistula. A more detailed description of the x-ray picture in Crohn's disease, see Chapter "x-Ray examination of the digestive system".

Fig. 45. "Symptom strings" when bole: Krona (x-ray).
Arrow indicates the plot ileum affected by Crohn's disease.