Crohn's disease of the stomach and duodenum.
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Biomedical subjects
Publications and source records attributed to D Maklansky.
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Fat necrosis in the mesentery is an unusual complication of an adjacent inflammatory process. This report demonstrates a case of fat necrosis resulting in multiple irregularly firm masses measuring up to 4.5 cm. in diameter which produced extrinsic pressure on the cecum and ascending colon, simulating a carcinoma radiographically and at surgery. The fat necrosis was caused by chronic appendicitis in association with pylephlebitis.
Recent advances have permitted close correlation of characteristic roentgen signs with the pathophysiologic alterations in lymphoreticular disorders of the gastrointestinal tract. The background of primary and secondary immunoglobin disorders with gastrointestinal manifestations is reviewed. The roentgenographic alterations in the small bowel of the enteropathic immunoglobulin deficiency syndromes and in lymphoma of the small bowel, stomach, and colon are discussed and illustrated in detail.
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Pneumatosis cystoides coli in most cases is a disease of unknown etiology. In a few patients, it is secondary to an infarction or ulcerative colitis. Associated pulmonary emphysema is not uncommon. The gas pockets, whcih may be of varying size, can be identified along the contour of the bowel. The left side of the colon is more frequently involved than the right. The lesion is usually segmental. The rectum is almost always spared. Symptoms are negligible and operation is not required.
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This case serves to illustrate the multiple routes which may occur in the dissemination of carcinoma of the stomach of the large bowel. Spread along the gastrocolic ligament involves the superior aspect of the transverse colon with limitation laterally by the phrenicocolic ligament. Once ascites has developed there is spread along the superior border of the sigmoid and lateral margin of the right side of the colon.
In this article the authors present a detailed classification of the various immunoglobulin deficiency states that have gastrointestinal manifestations, and describe the roentgenographic features of these disorders.
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