1. Two hundred eighty-four ulcerative lesions found in 45 patients with inflammatory y small bowel disease, which were operated on or dissected in Juntendo University Hospital during the 11 years from January 1973 to December 1983, were studied clinically and pathologically. For the basis of x-ray diagnosis of inflammtory small bowel disease, the shape and distribution pattern of the ulcerations were analyzed.
Ulcerations of inflammatory disease are divided by their shape into three groupes, “Point”, “Line” and “Area”.
Distribution patterns of the lesions are “Single” and multiplicity, which was classified into “Sporadic”, “Skip”, “Segmental” and “Diffuse”.
Characteristic findings were found in each inflammatory disease.
In intestinal tuberculosis, annular and girdle ulcerations could often be seen and the distribution pattern was “Single” or “Sporadic”. Typical findings of Crohn's disease were longitudinal and irregular-shaped shallow ulceration with or without cobblestone appearance and multiple ulcerations, such as “Skip” lesions, could be seen at the proximal side of longitudinal ulcer. The lesions so-called “Simple Ulcer” and intestinal Behcet's disease were “Single” or multiple, deep and big ulcerations on or near Bauhin's valve. Usually, ischemic colitis has longitudinal ulcerations could be seen in ischemic enteritis. In amyloidosis and celiac disease in our cases, no ulcerative lesion could be found.
2. The double contrast method of the small bowel by means of duodenal intubation was undertaken 375 times in 337 patients from January 1979 to April 1984 in the gastrointestinal section of our hospital.
Estimations of this method were as follows,
1) Good double contrast views of the upper and middle parts of the small bowel could be obtained nearly always in routine examination. In detailed examination, good results could be obtained at every desired part of the small bowel.
2) The double contrast method is best suited for visualizing not only big or medium-sized, but small and fine ulcerations.
3. Inflammatory small bowel diseases should be diagnosed by double contrast pictures within thinking about the shape of ulceration and the distribution pattern.
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