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ISSN: 2475-3181
Journal of Hepatology and Gastrointestinal disorders
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Disseminated Gastrointestinal Polyposis on Multidetector CT Enteroclysis

Dhirendra Ray*, Rohini Gupta and Brij B Thukral

Department of Radiology, VMMC & Safdarjung Hospital New Delhi-110029, India

Corresponding Author:
Dhirendra Ray
Department of Radiology
VMMC & Safdarjung Hospital New Delhi-110029, India
Tel: 91-9310336805
E-mail: dhirendrarayvns@gmail.com

Received Date: November 24, 2015 Accepted Date: November 30, 2015 Published Date: December 07, 2015

Citation: Ray D, Gupta R, Thukral BB (2015) Disseminated Gastrointestinal Polyposis on Multidetector CT Enteroclysis. J Hepatol Gastroint Dis 1:i103. doi:10.4172/2475-3181.1000i103

Copyright: © 2015 Ray D, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Clinical Images

A 35-year-old male presented with chronic digestive complaints referred to our department for contrast CT enteroclysis study of the abdomen. Multidetector CT enteroclysis study was done after nasojejunal intubation and administration of oral (neutral) intravenous contrast.

The study reveals multifocal, irregular, enhancing soft tissue lesion along peritoneal surface wilt associated scalloping of liver margin and ascites (Figure 1A). There were multiple enhancing nodular intraluminal polyps starting from pylorus of stomach.

There were also nodular enhancing deposits on omental surface (Figure 1B). Irregularly marinated, enhancing nodular lesion was seen over omental surface, invading anterior abdominal wall muscle layer.

hepatology-gastrointestinal-disorders-Axial

Figure 1: (A) Axial CT enteroclysis image showing enhancing soft tissue deposit along peritoneal surface (with associated scalloping of liver margin), omental surface and ascites (B) Omental surface showing nodular enhancing deposits with polyp noted in pylorus of stomach.

Ileo-colic intussusception was seen with enhancing soft tissue along intussuscepted segment of bowel (Figure 2A). It was long segment intussusception with polyp at lead paint of intussusception. Jejunum and ileal segment of bowel were diffusely showing multiple variable sized polyps. Soft tissue deposits were also seen in retroperitoneum (Figure 2B).

hepatology-gastrointestinal-disorders-ileo-colic

Figure 2: Long segment ileo-colic intussusception is seen with polyp at lead point. Multiple variable sized intensely enhancing intraluminal polyps are seen diffusely in small bowl.

Coronal reformatted images showed better visualization and characterization of polyposis. Polyps were not only varying in sizes but were sessile to pedunculated. Deposit on peritoneal surface better seen it coronal images mainly it right subdiaphragmatic and pelvic region.

Peritoneal deposit in pelvic region were relatively larger it size as compared to cranial lesions. Ascites was extending from subdiaphragmatic region to pelvic cavity (Figure 3).

hepatology-gastrointestinal-disorders-Coronal-reformatted

Figure 3: Coronal reformatted images showing better visualization and characterization of polyposis

So in conclusion, multiple variable sized polyps, extending from pylorus of stomach to distal ileum will long segment ileo-colic intussusception, multiple deposits and ascites were the CT enteroclysis finding histopathological examination reveals adenocarcinomatous changes. So final diagnosis of disseminated gastrointestinal polyposis with adenocarcinoma was concluded [1].

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