What does thickening of terminal ileum mean?

Ileocecal thickening (ICT) is a common finding on radiological imaging. It can be caused by a variety of inflammatory, infectious, or neoplastic conditions, and evaluating a patient of ICT can be a challenging task. Intestinal tuberculosis (ITB), Crohn’s disease (CD), and adenocarcinoma are the most common causes.

What is terminal ileal inflammation?

Terminal ileitis (TI) is an inflammatory condition of the terminal portion of the ileum that may occur acutely with right lower quadrant pain followed or not by diarrhea, or exhibit chronic obstructive symptoms and bleeding and normally it is associated to Crohn’s disease (CD) although it may be associated to other …

Can terminal ileitis cured?

It is a life-long chronic condition which cannot currently be cured and is part of a group of conditions known as inflammatory bowel disease (IBD).

How is terminal ileitis treated?

Based on the results of the diagnostic tests, ileitis may be treated with medications including antibiotics, corticosteroids, anti-inflammatories, antidiarrheal and immune-suppressing medications, as well as dietary supplements to reduce inflammation and manage associated symptoms.

Can colonoscopy see terminal ileum?

Colonoscopy passes a long, flexible colonoscope through the anal canal, to reach the large intestine (colon). Assuming there are no obstructions or strictures (narrowings), the colonoscope can reach right up to the caecum and terminal ileum. For the procedure, you will lie on your left side on an examination table.

What is a normal terminal ileum?

The terminal ileum is located on the right side of the abdominopelvic cavity in the umbilical and hypogastric regions. It is a tube about 1.25 to 1.5 inches (3 to 4 cm) long at the end of the ileum and terminates at the ileocecal sphincter.

Is ileitis always Crohns?

Terminal ileitis is not always Crohn’s disease.

What is normal terminal ileum?

The terminal ileum is the distal end of the small intestine that intersects with the large intestine. It contains the ileocecal sphincter, a smooth muscle sphincter that controls the flow of chyme into the large intestine.

Why is the ileal and cecal wall thickening?

In tropical and developing countries, infective diseases like tuberculosis (TB) may also result in ileocecal wall thickening and thus expand the list of differential diagnosis. Sometimes, poor distension of the bowel may be erroneously reported as bowel wall thickening.

What is the differential diagnosis of bowel wall thickening?

The differential diagnosis of a thickened bowel wall that shows homogenous attenuation on CT includes submucosal hemorrhage or hematoma [ 8, 9 ], infarcted bowel [ 10, 11 ], neoplasm [ 12, 13, 14, 15 ], chronic Crohn’s disease [ 3 ], radiation injury [ 10 ], and pseudothickening related to incomplete distention and residual fluid [ 1 ].

Which is the differential diagnosis of terminal ileitis?

The differential diagnosis for a terminal ileitis is quite extensive, and includes: Salmonella enterica serotype Typhi (typhoid fever) 1. Dilauro S, Crum-cianflone NF. Ileitis: when it is not Crohn’s disease.

What to do about ileocecal wall thickening on CT?

A majority of patients with ileocecal wall thickening on CT have an underlying disease and should be further investigated by ileocolonoscopy and biopsy.