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P184 Simplifying the meaning of small bowel thickening

S. Campos*, P. Figueiredo, A. Oliveira, C. Sofia

Centro Hospitalar Universitário Coimbra, Gastroenterology, Coimbra, Portugal

Background

Small bowel thickening (SBT) is a frequent finding. In its presence, we are often faced with a long list of differential diagnoses and the classic recommendation of "clinical- laboratory correlation." The aim of this study was to identify the frequency of the various etiologies for SBT, in order to minimize the gap in radiological literature and provide a better therapeutic strategy for these patients.

Methods

Retrospective study including all patients admitted for clarification of SBT, in the time period between January 2010 - July 2013. Evaluation of the epidemiological, clinical, imaging, endoscopic, histological and microbiological data and the final diagnosis.

Results

119 patients were included with SBT documented on abdominal ultrasound and / or CT performed in the emergency department: 63.9% female; mean age 46.7 years (15-85 years); 87.4% with abdominal pain. Most common location of SBT: ileum in 58.8%. Investigations: total colonoscopy with / without ileoscopy terminal in 54.6%; enteroscopy in 4 cases; stool cultures in 29.9% of patients. Etiologies: 24.3% infectious; 20.8% primary inflammatory (1 Behçet's disease, other - Crohn's disease); ischemic 5.8%; 5.8% reactive inflammatory (acute appendicitis); 5.8% neoplastic; 5.0% iatrogenic (5 radiation enteritis; 1ACEi angioedema); 1.6% obstruction bowel (hernia). In 31.0% cases it was not possible to reach a final diagnosis. 96 patients underwent radiological reevaluation with enteroCT, 41.6 % of which had no longer any changes in control. In the remaining patients, the enteroCT findings were in agreement with those suggested at admission.

Conclusion

The SBT is a relatively nonspecific feature associated with a wide spectrum of clinical conditions, most of which are acute. The most common etiology for the SBT is infectious. The enteroCT findings were consistent with those at admission. Epidemiological information from this study can be used as an additional tool in the management of SBT and in narrowing its differential diagnosis.