264.ACR GI Learning File (Case2)

每天朗读一段医学影像学英语文章

History

29-year-old female with long-standing illness. Two images from a barium enema are submitted; one before air has entered the terminal ileum (Fig 1) and one after air has refluxed into the terminal ileum (Fig 2).

Fig 1 and Fig 2

The terminal ileum is diffusely narrowed. It mildly distends when air refluxes into the small intestine. Several small ulcers (black arrows) are identified in Fig 1A. The cecum is markedly contracted (white arrow); the appendix is identified (arrowhead).

Fig 1-1 demonstrates the so-called "string sign" of Crohn's disease, a form of narrowing reminiscent of a "frayed string". Note how the lumen distends with air, indicating that the narrowing is not fixed in diameter. The linear ulcers throughout the mucosa indicate that the Crohn's disease may improve with medical therapy. The contracted cecum is a finding more typical of tuberculosis, an entity that should be included in your differential diagnosis in this case.

Notes:

1. barium [ˈberiəm] n. 钡

2. enema [ˈɛnəmə] 灌肠剂

3. ileum [ˈɪliəm] n. 回肠

4. refluxe ['ri:ˌflʌks] n. 逆流，退潮

5. intestine [ɪnˈtɛstɪn] n.  肠

6. ulcer [ˈʌlsɚ] n. 溃疡

7. cecum ['si:kəm] n. 盲肠

8. appendix [əˈpɛndɪks] n. 阑尾

9. reminiscent [ˌrɛməˈnɪsənt] adj. 怀旧的; 回忆往事的; n.回忆录作者

10. lumen [ˈlumən] n.（管） 腔

来源：每天朗读一段医学影像学英语文章

圈主

深圳市人民医院放射科副主任医师杨敏洁

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