CT detection of benign and malignant abnormalities of the small bowel

The authors analysed the CT findings in 60 normal subjects and 14 patients with small bowel disease to assess the ability of CT to detect wall thickening. The patients all had a small bowel wall thickness larger than 0.5 cm. Benignity could not be distinguished from malignancy solely on the pattern of small bowel thickening. Thus, Crohn's disease could not be differentiated from intestinal Hodgkin's disease or post radiation therapy ileitis. Intra- and extramural masses are also a common but non-specific pattern; they can be associated with small bowel wall thickening and have been encountered in different situations such as duodenal duplication, jejunal haematoma or adenocarcinoma. Knowledge of normal anatomy, optimal endoluminal opacification and careful attention to the appearance of the small bowel are recommended in every CT survey of the abdomen.