Year 2023 / Volume 115 / Number 8
Digestive Diseases Image
Effectiveness of ultrasound in the differential diagnosis of ileitis detected by computed tomography

450-451

DOI: 10.17235/reed.2022.9011/2022

Irene González Díaz, Joaquín Poza Cordón, Olivia Crivillén Anguita, Santiago Valderrábano,

Abstract
CASE REPORT A 86-year-old man with a recent history of stent placement for infrarenal aortic aneurysm arrives to the emergency department with abdominal pain. Computed tomography (CT) is performed to rule out complications of the endovascular procedure. The CT showed a loop of ileum with decreased caliber, fat trabeculation and hypervascularity causing proximal dilatation. No signs of ischemia or complications related to the prosthesis were observed. He was admitted to our service due to findings of non-specific ileitis. An intestinal ultrasound was performed and revealed a short segment of proximal ileum with pathological wall thickening with an intraluminal birefringent filamentary hyperechoic material (foreign body), which crossed all the layers of the wall. In the following days serial ultrasounds were performed showing that the foreign body remained in the same location and it was decided to perform surgery. During surgery the foreign body turned out to be a blister which conditioned an ileitis. Finally, intestinal resection was performed and the patient presented good clinical evolution. DISCUSSION The most validated technique for the diagnosis of foreign bodies is CT (1). However, intestinal ultrasound could help in its identification, especially for the non-radiopaque ingested material. On the other hand, it is especially useful in the pediatric age, where exposure to ionizing radiation should be avoided (2,3). In our case, it allowed not only to establish the diagnosis immediately but also to evaluate the evolutionary behavior of the same in terms of its mobilization or detection of local complications.
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References
1. Birk M, Bauerfeind P, Deprez PH, et al. Removal of foreign bodies in the upper gastrointestinal tract in adults: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy. 2016 May;48(5):489-96. doi: 10.1055/s-0042-100456. Epub 2016 Feb 10. PMID: 26862844.
2. Salmon M, Doniger SJ. Ingested foreign bodies: A case series demonstrating a novel application of point-of-care ultrasonography in children. Pediatr Emerg Care 2013; 29: 870–3.
3. Buonsenso D, Chiaretti A, Curatola A et al. Pediatrician performed point-of-care ultrasound for the detection of ingested foreign bodies: case series and review of the literature. J Ultrasound. 2021 Mar;24(1):107-114.
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González Díaz I, Poza Cordón J, Crivillén Anguita O, Valderrábano S. Effectiveness of ultrasound in the differential diagnosis of ileitis detected by computed tomography . 9011/2022


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Publication history

Received: 15/06/2022

Accepted: 21/06/2022

Online First: 30/06/2022

Published: 26/07/2023

Article Online First time: 15 days

Article editing time: 406 days


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