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Ileocecal thickening: Clinical approach to a common problem
Roshan Agarwala1, Abhi K Singh2, Jimil Shah1
1Department of Gastroenterology Postgraduate Institute of Medical Education and Research Chandigarh India.
JGH Open : an Open Access Journal of Gastroenterology and Hepatology
|December 14, 2019
Summary
Ileocecal thickening (ICT) presents a diagnostic challenge, often stemming from inflammatory, infectious, or neoplastic conditions. A systematic approach integrating clinical, imaging, and pathological data is crucial for accurate diagnosis and management.
Area of Science:
- Gastroenterology
- Radiology
- Pathology
Background:
- Ileocecal thickening (ICT) is a frequent radiological finding with diverse etiologies.
- Differentiating between common causes like intestinal tuberculosis (ITB), Crohn's disease (CD), and adenocarcinoma is clinically challenging.
- Nonspecific findings and challenging histopathology can complicate definitive diagnosis.
Purpose of the Study:
- To review the various causes of ICT.
- To present a systematic clinical approach for managing ICT.
Main Methods:
- Radiological assessment of thickening characteristics (site, extent, pattern) and associated findings.
- Integration of clinical, biochemical, and laboratory data.
- Utilization of ileocolonoscopy and histopathology for tissue diagnosis.
Main Results:
- Common causes include ITB, CD, and adenocarcinoma, but other infections and neoplasms must be considered.
- Imaging details and associated findings guide the diagnostic process.
- Histopathology, while often the gold standard, can yield nonspecific results.
Conclusions:
- A multidisciplinary approach combining clinical, imaging, endoscopic, and histological findings is essential for diagnosing ICT.
- A systematic evaluation is key to overcoming diagnostic challenges associated with ICT.
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