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Adynamic ileus: PIMM
postoperative (#1); inflammatory (often sentinel loop) � pancreatitis, appendicitis, cholecystitis, diverticulitis, peritonitis; metabolic � low K+, Ca++, Mg++; medication � morphine
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Mechanical SBO:
adhesion, hernia, tumor, gallstone, inflammation with strictures
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Malabsorption patterns: dilatation, dilution, delay; predominantly thick/irregular folds �
- Whipple�s, MAI, Strongyloides (proximal), amyloid, Giardia (jejunum), GVH, Cryptosporidium (jejunum), lymphoma, lymphangiectasia, mastocytosis, eosinophilic gastroenteritis;
- Malabsorption patterns: dilatation, dilution, delay predominantly dilated loops and normal folds �
- sprue (#1), obstruction, ileus, scleroderma, medication
- Thick folds without malabsorption pattern: criteria �
- folds >3mm, uniformly thickened if diffuse, nodular thickening (pinkyprinting) if focal with stack of coins appearance;
- Thick folds without malabsorption pattern: submucosal edema �
- ischemia, infection, radiation, hypoproteinemia, GVH;
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Thick folds without malabsorption pattern: submucosal tumor �
lymphoma, leukemia,
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Thick folds without malabsorption pattern: submucosal hemorrhage �
Henoch-Schonlein purpura, hemophilia, anticoagulation
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Tubular bowel:
Cryptosporidium, sprue (proximal), lymphoma, GVH, radiation, ischemia, Strongyloides (proximal)
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Nodules:
mastocytosis, nodular lymphoid hyperplasia, lymphoma, mets, polyps, Crohn�s, eosinophilic gastroenteritis, TB, infection, amyloid, lymphangiectasia, Whipple�s, Waldenstrom�s macroglobulinemia
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Diffuse tiny nodules:
lymphoid hyperplasia (#1), hypogammaglobulinemia, Giardia, Whipple�s, Waldenstrom�s
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Small bowel tumors: benign �
adenoma (#1), leiomyoma (#2), lipoma, hemangioma, neurogenic tumors, Brunner gland hyperplasia, heterotopic pancreatic tissue;
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Small bowel tumors: malignant �
mets (melanoma, RCC, breast, KS), lymphoma, carcinoid (#1 primary tumor), leiomyosarcoma (large ulcerating), adenocarcinoma; polyposis syndromes
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Small bowel stricture:
Crohn�s, lymphoma, mets, infection, radiation, ischemia, adenoCA, extrinsic compression, NSAIDs; focal stricture with shouldering � adenoCA (#1), breast mets, TB
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Coiled spring:
intussusception, intramural hematoma
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Large ulcerated mass (endoexoenteric):
lymphoma, leiomyosarcoma, mets (melanoma), interloop abscess
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Diverticula:
small bowel, Meckel�s
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Intraluminal filling defects:
parasites (Ascaris, tapeworm), bezoar, foreign body, gallstone, lipoma
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Enteric fistulas:
Crohn�s, diverticulitis, CA, TB, radiation, surgery, iatrogenic
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Serosal:
carcinoid, serosal mets, diverticulitis, appendicitis, endometriosis
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Mesenteric bowel ischemia: occlusive �
emboli (afib, LV aneurysm), arterial thrombosis (atherosclerosis), venous thrombosis (portal HTN, pancreatitis, tumor, hypercoagulable state, drugs);
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Mesenteric bowel ischemia: nonocclusive �
low flow state
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Shortened transit time:
anxiety, hyperthyroid, medication (reglan), partial SBO
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