Enteritis

X-ray diagnostics enteritis is based on a functional and direct signs.
Functional characteristics enteritis, rather gastroenteritis, consist of changes of tone and motor function of the stomach and small intestine, and impaired secretion and suction capacity (Gutzeit, Kuhlmann, 1932).
On the part of the small intestine, attention disorders of locomotor function. Often there is a delay in primary loops jejunum, where he meets reinforced nabuhnet transverse folds, with the formation of massive inflammatory pillows, in some cases, may narrowing of the lumen of the intestine. These changes are accompanied spastic banners. Above this narrowing of the loop of small bowel stretch and become a large diameter of the lumen. After overcoming such obstacles begins filling the entire small intestine, and found the uneven distribution of contrast due to concomitant spastic changes.
General promotion of the contrast medium through the small intestine enteritis in most cases is accelerated, and after 1,5-2 hours, you can see the location of barium not only in the distal small intestine, but in fairly significant quantities in a thick, mainly in the blind in the initial part of the ascending colon. Sometimes there is so fast that after 45 minutes in the small intestine lacking contrast (Cherigiee et al., 1957). However, there is a delay and motor function with the formation of long iliostasi. Delay motor functions is accompanied by a significant accumulation of fluid. Together with gases that appear in the small intestine as a result of improved fermentation processes and the possibility of the emergence of putrefactive changes in the course of the small intestine are defined small horizontal levels with gas accumulations under them (Fig. 109).

Fig. 109. Hypersecretory enteritis (x-ray). Gas accumulations and horizontal fluid levels in the small intestine.

Infringements of impellent functions of the small intestine gave rise to the division of enteritis on hypermotor and Geometrie, and both those and others can be enhanced exudation and become gipermotorika - or hipopotamo-hypersecretory-enteritis.
Attaching great importance functional signs enteritis, can be considered diagnostically valuable only as positive, and in a thorough comparison with clinical and microscopic findings. In x-rays enteritis, plays a significant role terrain mucosa. However, not always mentioned functional signs can occur when expressed enteritis, identified on the basis of materials coprological analysis.
Radiographic manifestations enteritis are characterized by the following changes on the part of the mucous membrane. Marked stable nabuhnet folds with uneven their thickening and strain relief. In acute and worsening of chronic enteritis clarity relief smeared by the presence of fluid in the gut. Folds lose picture "Cirrus" figure, and formed mixed relief uneven swelling submucosal layer and the emergence of Islands inflammatory hyperplasia (Fig. 110). The outlines of broken circuits intestine become uneven graininess, alternating with the smoothness of the walls.

Fig. 110. Strain relief of the mucosa of the small intestine when enteritis (x-ray).

The enteritis accompany dyskinesia, which have aterogennoe origin. By themselves, functional abnormalities when enteritis represent dyskinetic processes depending on their manifestations can increase its clinical course.
Special x-ray features characterize granulomatous enteritis, most often manifested in the form of regional ileitis, called "Crohn's disease".
Symptoms of Crohn's disease in the x-ray image remind picture infiltrating tumors. The bowel lumen, respectively tapering either in the form of a tube of the wrong form, or conically. Often the narrowing of the lumen of the intestine reaches more degrees. Then the affected area takes the form of "lace". Prevalence of the process can be up to 50 cm and more.
On grounds related granulomatous defeat of ulcerated during the modified Department intestine are leakages contrast medium, making x-ray image along the destruction could have millburngate shape. Affected part of the colon relatively clearly distinguished from healthy tissue. In the area of the narrowing of the folds of mucous indistinguishable. Anatomical narrowing may increase spastic contractions of the intestine. Before narrowed section of intestine are sometimes observed expansion of the lumen, amounting in some cases to the big sizes. Pronounced stenotic changes may lead K. symptoms of intestinal obstruction. Sometimes the narrowed area is accompanied by a thickening of the walls that by touching is defined as a tumor. Diagnosis of Crohn's disease is not simple, and it is necessary to differentiate this defeat with changes in tuberculosis (Bockus, 1964, and others).
Localization of Crohn's disease is not limited by the terminal ileum. Currently there are descriptions localize it in the duodenum and stomach, thin and thick intestines.
In 1945 the Golden describe a new form of terminal ileitis, which differs from Crohn's disease fact that there are no sclerotic changes. X-ray picture of this disease is characterized by changes in the mucous membrane of the distal end of the ileum in the appearance of the round prosvetlenie value with pepper or lentil grain in the amount reminiscent of the picture of polyposis. In some cases fold increase, and there may be swelling of the ileocecal valve. Such changes mucous definable only with appropriate palpation and dosed compression. This disease is called "esclerosis terminal ileit", "follicular enteritis", "catarrhal terminal ileit", "lymphoid terminal ileit" (Prevot and Lassrich).