Small bowel infectious and inflammatory disease

Abstract

The small bowel is relatively inaccessible to clinical and endoscopic examination. Imaging plays an important role, and barium fluoroscopy is gradually being replaced by cross-sectional modalities. The relative merits of the different imaging techniques are reviewed, and patterns of abnormality which aid in differential diagnosis are explored. In the developed countries of the northern hemisphere, the most prevalent inflammatory condition of the small bowel is Crohn's disease, and the radiological features are illustrated in detail. Other inflammatory conditions, such as appendix mass, Behçet's and eosinophilic enteritis are reviewed. Infections and infestations of the small bowel are commoner in tropical climates. Tuberculosis, Yersiniosis and Actinomycosis, amongst others, are illustrated, together with worm infestations. The differential diagnosis of terminal ileitis is explored, plus special scenarios, such as the immunocompromised patient.