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Terminal ileal stricture

¹ Department of Gastroenterology, Stanley Medical College Hospital, Chennai, India
² GKNM Hospital, Coimbatore, India
³ Leicester General Hospital, Leicester, UK

Correspondence to:
Correspondence to:
Dr V Jayanthi, M 97/5 MIG Flats, Besant Nagar, Chennai 90, India 600 090;
drjayant1@vsnl.com

Submitted 10 April 2002
Accepted 11 June 2002

The first 150 words of the full text of this article appear below.

A women, aged 46 years, presented with intermittent periumbilical pain for three years, each episode lasting for 10 to 15 days and at four to six months intervals for three years; antispasmodics often relieved the pain. She also had intermittent diarrhoea. Recently she had an appendicectomy. The retrocaecal appendix was densely adherent to the caecal wall. There was gross thickening of the terminal ileum and mesentery. The postoperative period was uneventful. The appendix showed features of acute inflammation.

INVESTIGATIONS
Haemoglobin and blood glucose concentrations were normal. A chest x ray film was normal, antimycobacterial antibody was negative, and C reactive protein was normal. Computed tomography confirmed thickening of the mesentery and the bowel wall. Terminal ileoscopy and biopsy were non-contributory. A small bowel enema (fig 1) was performed.

View larger version (105K): [in this window] [in a new window]   Figure 1 Enteroclysis showing a smooth stricture of the terminal ileum.

1. What does the small bowel enema show?
   
2. What is the differential . . . [Full text of this article]