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    Go to the top of the page   ID: 20040207222335 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Celiac disease
    D Weber. Celiac disease. PedRad [serial online] vol 4, no. 2.
    URL: www.PedRad.info/?search=20040207222335


     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    D. Weber (Uniklinik Leipzig)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    8 Years  

     
     Pediatric Radiology CasesGender:

    Female  

     
     Pediatric Radiology CasesRegion-Organ:

    Other  

     
     Pediatric Radiology CasesMost likely etiology:

    other  

     
     Pediatric Radiology CasesHistory:

    8 year-old girl with a 3 week history of diarrhea, weight loss of about 2 kg and reoccurring stomach aches.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    Immunological with genetic determination.

    Gliadine/Gluten induced morphological changes of the small intestinal mucosal membranes with atrophy of the villi.

    Clinic: malabsorption

    Begin of illness is mostly in the 6th - 18th month of live, but it can also occur later. Which factors contribute to the clinical manifestation is still unclear.

    Increased rate for lymphomas.  

     
     Pediatric Radiology CasesRadiological findings:


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Widened fluid-distended intestinal loops in the left middle abdominal region with increased peristalsis (red arrow), but without wall-thickening (yellow arrow).




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Widened fluid-distended intestinal loops in the left middle abdominal region with increased peristalsis, but without wall-thickening. Minimal free fluid (red arrow).




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Multiple mesenterial lymph nodes (green arrows) reaching up to 19x12mm in size without hyperperfusion.




    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: In the initial examination, "bulls-eye" is seen in the left middle abdominal region (light blue arrow), without acute clinical signs. Apparently, this is a small intestinal invagination, which is, in the follow-up exam not seen anymore.

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Surgery / Histo  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Mesenterial lymphadenitis, enteritis  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Although all sonographic findings are unspecific, there are some that are often found in children with celiac disease:

    - slightly dilated small intestinal loops
    - slight, diffuse intestinal wall thickening
    - increased peristalsis
    - slightly enlarged mesenterial lymph nodes
    - slight widened superior mesenteric artery (increased perfusion)
    - slight widened superior mesenteric vein
    - free fluid
    - increased echogenicity of the liver

    Gluten-free diet lessens the clinical symptoms. A life-long diet is needed.  

     
     Pediatric Radiology CasesComments of the author about the case:

    The ultrasound findings are unspecific. It is not uncommon, however, to find unspecific changes in children with celiac disease!

    Do the mesenterial lymph-nodes always belong to the clinical picture?  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    1. Medline: Medline
    Rettenbacher T, Hollerweger A, Macheiner P, Huber S, Gritzmann N.
    Adult celiac disease: US signs.
    Radiology. 1999 May;211(2):389-94

    2. Medline: Medline
    Riccabona M, Rossipal E.
    Value of ultrasound in diagnosis of celiac disease
    Ultraschall Med. 1996 Feb;17(1):31-3.

    3. Medline: Medline
    Dietrich CF, Brunner V, Seifert H, Schreiber-Dietrich D, Caspary WF, Lembcke B.
    Intestinal B-mode sonography in patients with endemic sprue. Intestinal sonography in endemic sprue
    Ultraschall Med. 1999 Dec;20(6):242-7.
     

     
     Pediatric Radiology CasesKeywords:

    celiac disease, glutenenteropathy, nontropical sprue, invagination, mesenterial, mesentery, gluten, gliadin, enteritis, celiac, disease, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    D Weber. Celiac disease. PedRad [serial online] vol 4, no. 2.
    URL: www.PedRad.info/?search=20040207222335  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: Other
    or in the region: Other
    or in the tissue/organ:
    or with the etiology: other
     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     
    Celiac disease
    D Weber. Celiac disease. PedRad [serial online] vol 4, no. 2.
    URL: www.PedRad.info/?search=20040207222335


     

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    Celiac disease
    Other cases by these authors:

    Search D. Weber in Medline D. Weber (4)   

    Celiac disease  
     
    Celiac disease
    D Weber. Celiac disease. PedRad [serial online] vol 4, no. 2.
    URL: www.PedRad.info/?search=20040207222335


     

    Which diagnosis have other collegues guessed?


    • Mesenterial lymphadenitis
      Votes: 12 (52 %)


    • Celiac disease
      Votes: 8 (34 %)


    • Hodgkin's disease
      Votes: 1 (4 %)


    • Peutz-Jegher's Syndrome
      Votes: 2 (8 %)



        Total answers: 23

     
    Celiac disease
    D Weber. Celiac disease. PedRad [serial online] vol 4, no. 2.
    URL: www.PedRad.info/?search=20040207222335


     

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    Celiac disease
    D Weber. Celiac disease. PedRad [serial online] vol 4, no. 2.
    URL: www.PedRad.info/?search=20040207222335


     




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