VI J. R. VON RONNEN PREFACE This atlas is a selection of the roentgenograms of patients who visited the Radiology Department at the University Hospital in Leiden between 1970 and 1974. The heads of this department are Prof. J. R. von Ronnen and Prof. A. E. van Voorthuisen. In this atlas, the most frequently occurring radiological abnormalities of the small intestine are illustrated as clearly as possible - without the shadows caused by flocculation or segmentation of the contrast fluid. The author hopes it will be a positive contribution towards the attainment of the highest possible…mehr
VI J. R. VON RONNEN PREFACE This atlas is a selection of the roentgenograms of patients who visited the Radiology Department at the University Hospital in Leiden between 1970 and 1974. The heads of this department are Prof. J. R. von Ronnen and Prof. A. E. van Voorthuisen. In this atlas, the most frequently occurring radiological abnormalities of the small intestine are illustrated as clearly as possible - without the shadows caused by flocculation or segmentation of the contrast fluid. The author hopes it will be a positive contribution towards the attainment of the highest possible diagnostic score. It should be remembered that the key to good diagnostics is not only a perfect examination technique, but also the knowledge and character of the physician. If these factors are optimal, then the best possible series of roentgenograms will be obtained, at least as far as technique is concerned. All patients were examined by the enteroclysis technique. With this method of examinationof the small intestine, the contrast fluid is administered via an infusion directly into the duodenum instead of orally. The infusion method has added a new dimension to the radiological examination of the small intestine. This method has turned out to be especially suitable for the comparative evaluation of motility, and also for the study of disturbed motility.
I Introduction.- II Anatomy.- 1. Normal mucosa in the small intestine.- 2. Normal position of the intestine.- 3. Normal impressions on the intestine.- 4. Filling defects between the intestinal loops.- III Physiology.- 1. Innervation and motility.- 2. Gastric emptying and transit time.- IV The Contrast Medium.- General considerations.- 1. Sedimentation of the contrast medium.- 2. Flocculation of the contrast fluid.- 3. Segmentation of the contrast column.- 4. Additives to the contrast medium for the purpose of improving stability and adhesion.- 5. Relationship between viscosity, particle size and adhesion of the barium suspension.- 6. Specific gravity of the contrast fluid.- 7. Contrast media other than barium sulfate.- V Methods of Examination.- 1. 'Physiological' examination of the small intestine.- 2. Single administration of the contrast medium.- 3. Fractional administration of the contrast medium.- 4. Administration of cold fluids with the contrast medium.- 5. Administration of the contrast medium through a tube directly into the small intestine (enteroclysis).- 6. Retrograde administration of the contrast fluid.- 7. Combined methods of examination.- 8. Use of drugs to accelerate transit.- VI General Considerations.- VII The Enteral Contrast Infusion.- 1. Preparation of patients.- 2. Duodenal intubation.- 3. Partial gastrectomy.- 4. Special types of tubes.- 5. Administration of contrast fluid.- 6. Administration of water after the barium suspension.- 7. Administration of air after contrast fluid.- 8. Compression technique.- VIII Basic Signs of Abnormality.- 1. Changes in mucosal pattern.- 2. Lymph follicles - nodules - polyps.- 3. Foreign bodies and filling defects in the contrast fluid.- 4. Ulcerations.- 5. Deformation of the intestine.- 6. Dilution of thecontrast fluid - haziness - mucus secretion.- 7. Disintegration and misleading patterns.- 8. Malabsorption.- 9. Motility 160 Bibliography.- IX Inflammation and Inflammatory-Like Diseases.- 1. General.- 2. Crohn's disease.- 3. Reflux ileitis.- 4. Yersinia EC infections.- 5. Eosinophilic gastroenteritis.- 6. Radiation enteritis.- 7. Whipple's disease.- 8. Aspecific ulcers.- 9. Appendicular infiltrates.- 10. Zollinger-Ellison disease.- 11. Radiological manifestations of serum protein disorders.- X Tumors.- 1. General.- 2. Polyposis.- 3. Benign tumors.- 4. Semimalignant tumors.- 5. Malignant tumors.- 6. Metastasis 268 Bibliography.- XI Vascular Diseases.- 1. Ischemia due to impaired arterial flow.- 2. Impaired venous flow.- 3. Periodic vascular insufficiency.- 4. Hemorrhage.- XII Disturbed Motility.- 1. Drug-induced atony of the small bowel.- 2. Collagen diseases.- 3. Adult celiac disease.- 4. Amyloidosis.- XIII Congenital Anomalies.- 1. Abnormal positioning of the entire small bowel: disturbed rotation or fixation.- 2. Abnormal or fixed positioning of several intestinal loops: internal hernia.- 3. Duplications.- 4. Diverticulosis.- 5. Meckel's diverticulum.- XIV Ileus - Fusion - Bands - Volvulus - Intussusceptions - Incisional Hernia.- 1. Ileus.- 2. Fusion - Bands.- 3. Volvulus.- 4. Intussusceptions.- 5. Incisional hernia.
I Introduction.- II Anatomy.- 1. Normal mucosa in the small intestine.- 2. Normal position of the intestine.- 3. Normal impressions on the intestine.- 4. Filling defects between the intestinal loops.- III Physiology.- 1. Innervation and motility.- 2. Gastric emptying and transit time.- IV The Contrast Medium.- General considerations.- 1. Sedimentation of the contrast medium.- 2. Flocculation of the contrast fluid.- 3. Segmentation of the contrast column.- 4. Additives to the contrast medium for the purpose of improving stability and adhesion.- 5. Relationship between viscosity, particle size and adhesion of the barium suspension.- 6. Specific gravity of the contrast fluid.- 7. Contrast media other than barium sulfate.- V Methods of Examination.- 1. 'Physiological' examination of the small intestine.- 2. Single administration of the contrast medium.- 3. Fractional administration of the contrast medium.- 4. Administration of cold fluids with the contrast medium.- 5. Administration of the contrast medium through a tube directly into the small intestine (enteroclysis).- 6. Retrograde administration of the contrast fluid.- 7. Combined methods of examination.- 8. Use of drugs to accelerate transit.- VI General Considerations.- VII The Enteral Contrast Infusion.- 1. Preparation of patients.- 2. Duodenal intubation.- 3. Partial gastrectomy.- 4. Special types of tubes.- 5. Administration of contrast fluid.- 6. Administration of water after the barium suspension.- 7. Administration of air after contrast fluid.- 8. Compression technique.- VIII Basic Signs of Abnormality.- 1. Changes in mucosal pattern.- 2. Lymph follicles - nodules - polyps.- 3. Foreign bodies and filling defects in the contrast fluid.- 4. Ulcerations.- 5. Deformation of the intestine.- 6. Dilution of thecontrast fluid - haziness - mucus secretion.- 7. Disintegration and misleading patterns.- 8. Malabsorption.- 9. Motility 160 Bibliography.- IX Inflammation and Inflammatory-Like Diseases.- 1. General.- 2. Crohn's disease.- 3. Reflux ileitis.- 4. Yersinia EC infections.- 5. Eosinophilic gastroenteritis.- 6. Radiation enteritis.- 7. Whipple's disease.- 8. Aspecific ulcers.- 9. Appendicular infiltrates.- 10. Zollinger-Ellison disease.- 11. Radiological manifestations of serum protein disorders.- X Tumors.- 1. General.- 2. Polyposis.- 3. Benign tumors.- 4. Semimalignant tumors.- 5. Malignant tumors.- 6. Metastasis 268 Bibliography.- XI Vascular Diseases.- 1. Ischemia due to impaired arterial flow.- 2. Impaired venous flow.- 3. Periodic vascular insufficiency.- 4. Hemorrhage.- XII Disturbed Motility.- 1. Drug-induced atony of the small bowel.- 2. Collagen diseases.- 3. Adult celiac disease.- 4. Amyloidosis.- XIII Congenital Anomalies.- 1. Abnormal positioning of the entire small bowel: disturbed rotation or fixation.- 2. Abnormal or fixed positioning of several intestinal loops: internal hernia.- 3. Duplications.- 4. Diverticulosis.- 5. Meckel's diverticulum.- XIV Ileus - Fusion - Bands - Volvulus - Intussusceptions - Incisional Hernia.- 1. Ileus.- 2. Fusion - Bands.- 3. Volvulus.- 4. Intussusceptions.- 5. Incisional hernia.
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