The radiographic appearances of non-specific small intestinal ulceration

To determine the imaging characteristics of non-specific ulceration of the small intestine.

The radiographic investigations undertaken in three patients originally referred for visceral angiography in whom a histological diagnosis of non-specific ulceration of the small bowel was subsequently made were retrospectively reviewed. Two men and one woman aged from 17 to 24 years all presented with anaemia requiring blood transfusion. Visceral angiography was available for review in all three patients, abdominal computed tomography in two, and a small bowel enema and white cell scintigraphy in one.

In all three patients an angiographic abnormality was present within the ileum consisting of irregularity of the vasa recta, an area of subtle increased vascularity and early venous return. A long, non-branching vessel interpreted as a persistent vitello-intestinal artery was seen in two of these patients. A CT abnormality was present in two individuals consisting of a focal area of thickened small bowel. The single small bowel enema demonstrated a focal stricture and the white cell scan showed localized accumulation of radioactivity within the pelvis.

Non-specific small intestinal ulceration may produce abnormalities that are discernible on barium studies, computed tomography, radiolabelled white cell scanning and visceral angiography. Recognition of these findings may allow a pre-operative diagnosis of this condition.