Coeliac disease

  • Gluten-related immune-mediated enteropathy
  • In genetic susceptible individuals
  • 1 in 200 people
  • Malabsorption, diarrhea, weight loss, steatorrhea, malnutrition, anemia, abdominal pain
  • Greater risk of malignancy of small intestine – lymphoma (enteropathy associated T-cell lymphoma) and adenocarcinoma
  • Abnormal villous pattern in jejunal biopsy
  • Barium study
    • Dilatation of bowel loops
    • Increased intestinal fluid
    • Straightened and thickened valvulae conniventes in jejunum
    • Numerous mucosal folds in ileum (jejunisation)
    • Transient non-obstructive intussusception
  • CT
    • Bowel dilatation
    • Fluid excess
    • Bowel wall thickening
    • Jejunoileal fold patten reversal
    • Transient small bowel intussusception
    • Benign mesenteric lymphadenopathy with low attenuation centres
    • Mesenteric vascular engorgement
    • Complications
      • Cavitary mesenteric lymph node syndrome: enlarged, fluid-attenuation mesenteric lymph nodes with thin, peripherally enhancing rims
      • Ulcerative jejunoileitis: simulates Crohn disease
Read more

Scholz, Francis J., Jalil Afnan, and Spencer C. Behr. “CT findings in adult celiac disease.” Radiographics 31.4 (2011): 977-992.

Masselli, Gabriele, et al. “Celiac disease: evaluation with dynamic contrast-enhanced MR imaging.” Radiology 256.3 (2010): 783-790.