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Radiological findings in two patients with cow's milk allergic enterocolitis
Kouji Masumoto1, Yukiko Takahashi, Takanori Nakatsuji
1Department of Pediatric Surgery, Reproductive and Developmental Medicine, Kyushu University, Fukuoka, Japan. kmasu@pedsurg.med.kyushu-u.ac.jp
Insights
Cow's milk allergic enterocolitis in neonates can present with unique gastrointestinal contrast study findings. These radiological signs may aid in early diagnosis of this common pediatric condition.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Radiology
Background:
- Cow's milk allergic enterocolitis (CMAEC) is a frequent pediatric gastrointestinal disorder.
- Radiological findings in CMAEC, particularly from contrast studies, are infrequently documented.
Observation:
- This report details two Japanese neonate cases of CMAEC presenting with vomiting and bloody stool.
- Unique upper gastrointestinal contrast study findings included thickened, spasmodic, or ribbon-like small intestinal folds.
- One case exhibited delayed duodenojejunal passage, and another showed colonic spasms on lower GI contrast study.
Findings:
- Contrast studies revealed distinctive small intestinal mucosal fold abnormalities (thickening, spasm, ribbon-like appearance).
- Impaired passage between the duodenum and jejunum was observed in one patient.
- Segmental colonic spasm was noted in the lower gastrointestinal contrast study of one patient.
Implications:
- Radiologists and pediatric surgeons should recognize these unique contrast study findings.
- Enhanced awareness of these radiological signs can improve the suspicion and diagnosis of CMAEC in neonates.
- Gastrointestinal contrast studies may serve as a valuable tool in the diagnostic workup of neonatal CMAEC.
Abstract:
Cow's milk allergic enterocolitis is a common paediatric gastrointestinal disease. However, radiological findings from contrast studies have rarely been reported. We report two Japanese neonate patients with cow's milk allergic enterocolitis with vomiting, bloody stool and unique findings on upper gastrointestinal contrast study. Upper gastrointestinal contrast study showed folds of the small intestine to be thickened, such as in spasm, or ribbon-like cords in both cases. There was also poor passage from the duodenum to the jejunum in one case. In addition, there were spastic findings on lower gastrointestinal contrast study in part of the large colon in one case. Clinicians, including paediatric surgeons, treating neonates with bloody stool and/or vomiting should thus be aware that unique findings on upper and lower gastrointestinal contrast studies may be useful in suspecting cases with cow's milk allergic enterocolitis.
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