Acta Oncol Tur.. 2009; 42(2): 69-73

Crohn Hastalýðýnda Multidedektör Bilgisayarlý Tomografi Bulgularý

Kemal ARDA¹, Nazan ÇÝLEDAй
SB Dr. Abdurrahman Yurtarslan Ankara Onkoloji Eðitim ve Araþtýrma Hastanesi, Radyoloji Bölümü, ANKARA

Crohn's disease is an idiopathic inflammatory bowel disease. Multidedector computed tomography is used in diagnoses and the management of the intramural, murat and extramural components of the gastrointestinal tract pathologies. VVith unknown eti-ology, and has variabie responses to medical and surgical management. Barium studies and colonoscopy are the primary evaluation methods of the inflammatory changes of the mucosa; however, both of them provide little information on the extraintesti-nal extent of the disease. Ýn recent years, multidedector computed tomography became an important modality to evaluate the pathologic changes of the intraluminal, intramural, and mesenteric extent of the disease, and the attachment of the adjacent structures. Fourty-one patients (11 women, 30 men, age range 22-75 years, mean age 43.97 ± 13.96) with histological proven Crohn’s disease were examined with multidedector computed tomography. Ýn the computed tomography studies of 41 Crohn’s disease patients, segmental small bowel wall thickening were detected in 31 out of 41 cases (75.6%) , the thickening involved the terminal ileum were in 14 out of 41 (34.1 %) patients, and the different extends of the colonic wall thickening were detected in 21 out of 41 (51.2%) cases. Both small and large bowel loops were involved in 11 out of 41 (26.8%) Crohn’s disease patients. Abscesses were found in four out of 41 (9.7%) Crohn’s disease patients. Enlarged mesenteric lymph nodes were detected in 17 (41.4%) of them. Fistulas were detected in 8 out of 41 (19.5%>) patients, five of them ývere enterocutaneus, two of them were enterovesical fistulas, and one was bilioenteric fistula. Perforation was seen in one of the patients and right hemicolectomy was performed.

Keywords: Crohn’s disease, inflammatory bowel disease, MDCT.

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Multidedector Computed Tomography Findings of Crohn ’s Disease

Kemal ARDA¹, Nazan ÇÝLEDAй
SB Dr. Abdurrahman Yurtarslan Ankara Onkoloji Eðitim ve Araþtýrma Hastanesi, Radyoloji Bölümü, ANKARA

inflamatuvar baðýrsak hastalýklarýndan Crohn hastalýðýnýn taný ve takibinde ince kesit multidedektör bilgisayarlý tomografi görüntülemeyle gastrointestinal trakt patolojilerinin intraluminal, mu rai ve ekstraluminal komponentlerinin birlikte deðerlendirmesi yapýlabilmektedir. Baryumlu grafiler ve endoskopik inceleme, mukozaI inflamasyonun primer inceleme yöntemleridir. Ancak bu yöntemler kullanýlarak ekstramukozal ve mezenterik patolojiler deðerlendirilemez. Multidedektör bilgisayarlý tomografi ile Crohn hastalýðýnýn ekstramukozal, mezenterik komponentleri, komþu organ tutulumu, geliþen komplikasyonlar ile olgularýn tedaviye yanýtý ortaya konabilir. Crohn hastalýðý ön tanýsýyla takip edilen 41 olgunun (30 erkek, 11 kadýn; yaþ aralýðý 22-75, ortalama yaþ: 43.97 ± 13.96) multidedektör bilgisayarlý tomografi bulgulan sunulmuþtur. Kýrk bir olgunun 31 (%75.6)’inde ince baðýrsakta, 14 (%34.1)’ünde terminal ileumda, 21 (%51.2)’inde kolonda duvar kalýnlaþmasý, 11 (%26.8)'inde hem ince, hem de kalýn baðýrsak segmentlerinde tutulum, 4 (%9.7)’ünde apse, 17 (%41,4)’sinde mesenterik lenfadenopati, 8 (%19.5)’inde fistül saptanmýþtýr. Fistül saptanan olgulardan beþinde enterokütanöz, ikisinde enterovezikal ve birinde bilioenterik fistül görülmüþtür. Perforasyon saptanan bir olguya sað hemikolektomi uygulanmýþtýr.

Anahtar Kelimeler: Crohn hastalýðý, inflamatuvar baðýrsak hastalýðý, multidedektör bilgisayarlý tomografi.

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