need translation

here is my CT enterography report

I would appreciate any insight you have (Ill post on CD forum as well)
thank you very much!!

ABDOMEN:

LUNG BASES: No significant abnormality noted

LIVER, BILIARY TRACT: Too small to characterize subcentimeter hepatic dome hypoattenuating
lesion.

SPLEEN: No significant abnormality noted

PANCREAS: No significant abnormality noted

ADRENAL GLANDS: No significant abnormality noted

KIDNEYS, URETERS: No significant abnormality noted

RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.

CALCIFICATIONS IN ABDOMINAL AORTA AND ITS BRANCHES: None

BOWEL, MESENTERY: See below.

BONES, SOFT TISSUES: No significant abnormality noted

OTHER: No significant abnormality noted


PELVIS:

UTERUS, ADNEXA: Physiologic ovarian cysts.

BLADDER: No significant abnormality noted

LYMPH NODES: No significant abnormality noted

BOWEL, MESENTERY: Large volume of Volumen within the stomach. The jejunum is collapsed.
There is mild hyperenhancement of the terminal ileum spanning approximately 3.7 cm (series
201, image 76) which raises concern for Crohn's disease. There is a sigmoid colon is
underdistended (series 201, image 105) but mild colitis cannot be excluded.

BONES, SOFT TISSUES: Sclerotic focus in the superior right acetabulum may represent a
benign bone island.

OTHER: No significant abnormality noted

IMPRESSION:
1. Hyperenhancing terminal ileum raises concern for Crohn's disease.
2. Underdistended sigmoid colon; however, mild focal colitis cannot be excluded. No
specific findings to suggest ulcerative colitis otherwise.
3. Portions of bowel (particularly jejunum) not well distended by contrast with large
volume of enteric contrast remaining in stomach, may be due to timing of exam.

BOWEL, MESENTERY: Large volume of Volumen within the stomach. You still had a lot of the fluid you swallowed for the CT Scan within your stomach.

The jejunum is collapsed.
The small intestine is composed of three sections, the duodenum (where the small intestine joins the stomach), the ileum (where the small intestine joins the large intestine), and the jejunum is everything in-between. The jejunum was collapsed (as the liquid was still within your stomach). Therefore they can't tell much about your jejunum, since it was collapsed/empty. It's noted again in the Impression section, item #3
3. Portions of bowel (particularly jejunum) not well distended by contrast with large volume of enteric contrast remaining in stomach, may be due to timing of exam.

Post Edited (iPoop) : 6/2/2016 12:39:19 PM (GMT-6)

BOWEL, MESENTERY:There is mild hyperenhancement of the terminal ileum spanning approximately 3.7 cm (series 201, image 76) which raises concern for Crohn's disease. You have inflammation of the Ileum, also known as Ileitis. The Ileum is where the small intestine joins the large intestine. That inflammation was seen as wall thickening (hyperenhancement) to 3.7mm within your CT Scan.

An inflamed Ileum does raise concern for Crohn's disease. However, you do have ulcerative colitis with pancolitis, and therefore Backwash Ileitis is a possibility and must be ruled out. An inflamed Ileum can also be caused by cdiff and other bacterial infections.
Source:www.ncbi.nlm.nih.gov/pmc/articles/PMC2914216/

3.1. Radiological signs of Crohn’s activity
Wall (mural) thickening greater than 3 mm (yours was 3.7mm) in a distended (expanded/full of air or fluid) bowel correlated highly with disease activity and, was present in up to 82.5% of patients, it was the most frequently observed CT finding in Crohn’s disease. When associated with wall (mural) hyperenhancement ... is the most specific CT finding for active Crohn’s disease.
www.sciencedirect.com/science/article/pii/S0378603X1200068X

The Ileum can be inflamed in both Crohn's and UC-pancolitis patients. As such, I'm not sure this is conclusive one way or another. It totally sucks that your jejunum was collapsed...

Post Edited (iPoop) : 6/2/2016 12:39:00 PM (GMT-6)

LIVER, BILIARY TRACT: Too small to characterize subcentimeter hepatic dome hypoattenuating
lesion.
This is a real toughy. It's to small to characterize (they don't know what it is due to it's size). I think it's nothing to really worry about, but I would ask for clarification.
From what I can tell, if you don't have any known malignancies (cancers) then they are most likely non cancerous (benign) and it's best if they saw one, or just a few, rather than a lot. The liver can get lots of deposits of various things, most of which are not a concern. In some instances (rare) they are cancerous.
Source: www.radiologyassistant.nl/en/p45a5e818c709d/liver-incidentalomas.html

BONES, SOFT TISSUES: Sclerotic focus in the superior right acetabulum may represent a
benign bone island.
They found a bone island near your right hip joint which is present from birth (cogenal). It's common and benign, no worries. A bone island (an enostosis) is a common small focus of compact bone, usually seen as an incidental finding in a CT scan or MRI. Bone islands may occur anywhere in the skeleton, although there is some predilection for pelvis, long bones, spine and ribs. Source:radiopaedia.org/articles/enostosis

Post Edited (iPoop) : 6/2/2016 12:38:47 PM (GMT-6)

So basically there wasn't much of a point of subjecting myself to all of that radiation? Because they missed the small bowel.

Wondering why he didn't mention the liver thing when he called me? I guess that means he isn't concerned

iPoop said...
Yeah, looks like the scan was a bust. You got that yummy contrast taste and radiation for not much but a few neat footnotes like the bone island. Maybe your doctor can tell more from this, but at least my assessment was it is a bust. If they HAD saw your whole small intestine they could either diagnose or rule out Crohn's...

I wonder if they are going to do anything differently to prevent this from happening again
i guess they take scans every several minutes so they will be able to get the right images