Barium follow through studyBarium follow through study

Ileocaecal region _ variety of Ileocaecal region _ variety of lesionslesions

By _ Dr Rekha KhareBy _ Dr Rekha Khare

M.D. RadiologyM.D. Radiology

Ileocaecal region _ NormalIleocaecal region _ Normal

Deformed cecum, dilated Deformed cecum, dilated terminal ileum and obtuse terminal ileum and obtuse

ileocecal angleileocecal angle

Multiple strictures _string signMultiple strictures _string sign

Poor filling of cecum,Poor filling of cecum,dilated terminal ileumdilated terminal ileum

H/O Rt hemicolectomy H/O Rt hemicolectomy Biopsy _ T.B.Biopsy _ T.B.

Bilateral active tuberculosisBilateral active tuberculosiswith ileocaecal T.Bwith ileocaecal T.B

On ATTOn ATTwith ileocaecal T.B. with ileocaecal T.B.

Spastic cecumSpastic cecumTransit time _ 10 hrsTransit time _ 10 hrs

Strictures, contractedStrictures, contractedcecum and distorted anglececum and distorted angle

Ileocecal T.B. Ileocecal T.B. stricture in transverse colon stricture in transverse colon

ascitic fluid cytology_ T.B. natureascitic fluid cytology_ T.B. nature

Transit time 13 hrsTransit time 13 hrsdeformed and mobile cecumdeformed and mobile cecum

Delayed gastric emptying timeDelayed gastric emptying timetransit time 8 hrs.transit time 8 hrs.

Malabsorption pattern ( 45 mts)Malabsorption pattern ( 45 mts)symptoms mimic like T.B.symptoms mimic like T.B.

Ileocecal region not seen after 8 Ileocecal region not seen after 8 hrshrs

stricure 2stricure 2ndnd part of duodenum part of duodenumbiopsy _ T.B.biopsy _ T.B.

Ileocecal region not seen after Ileocecal region not seen after 14 hrs14 hrs

on op. _ stricture at distal end of on op. _ stricture at distal end of jejunumjejunum

Bypass surgery doneBypass surgery done

Round worm infestation Round worm infestation linear filling defectslinear filling defects

Rt Hemicolectomy _ widespread Rt Hemicolectomy _ widespread involvement ? crohn’s diseaseinvolvement ? crohn’s disease

( biopsy not available)( biopsy not available)

Ileocecal T.B. _ before TtIleocecal T.B. _ before Tt

After Tt. After Tt. Pain not relievedPain not relieved

Mobile cecum _ supine Mobile cecum _ supine positionposition

Mobile cecum _ head down Mobile cecum _ head down positionposition

Mobile cecum _ head down Mobile cecum _ head down positionposition

Mobile cecum _ standing Mobile cecum _ standing positionposition

cecopexy donececopexy done

FinallyFinally

Majority ileocaecal T.B.Majority ileocaecal T.B.Few with pulmonary T.B.Few with pulmonary T.B.Mobile cacum might give vague Mobile cacum might give vague

symptoms like T.B.symptoms like T.B.

Thank you very muchThank you very much

have pleasant timehave pleasant time