Idiopathic localized dilatation of the ileum in adults: findings on barium studies.

Abstract

OBJECTIVE.Idiopathic localized dilatation of the ileum is a rare entity characterized by a sharply demarcated segmental dilatation of the small bowel that is in line with the and In one, the lesion was seen on a barium enema with reflux into the ileum. The mean age of patients was 52 years. In seven cases, pathologic correlation was available.In the other two patients, long-term clinical follow-up and repeat studies confirmed the diagnosis. Resected specimens showed a thin but otherwise normal wall with normal ganglion cells and nerve plexuses. Ulceration was noted in six of the seven resected cases. Two cases contained heterotopic gastric mucosa. Gi bleeding and/or anemia was the most common (77%) presenting symptom. Abdominal pain and/or obstruction was present in slightly less than half the patients (44%).RESULTS. Lesions were 6-21 cm long and 4-13 cm wide, and all were located in the ileum. The dilated segments were bilobate in three cases, multilobate in three, spherical in two, and tubular in the other. The dilated area was always in line with the long axis of the bowel, not projecting to the side. No surrounding masses were seen. Except in three patients in whom ulcers were noted, the mucosa was normal.CONCLUSION. Idiopathic localized dilatation of the ileum should be suspected whenever a sharply demarcated area of lobulated small bowel dilatation is seen in a middle-aged patient with occult Gi bleeding. The axial orientation distinguishes this condition from small bowel diverticula (including Meckel's). The lack of surrounding mass, mucosal irregularity, hypermotility, or fistulae help differentiate it from other causes of small bowel dilatation.

Dieulafoy’s lesion and segmental dilatation of the small bowel: An uncommon cause of gastrointestinal bleeding

“…5 Because mucosal ulceration is common with segmental dilation of the small bowel, anemia or abdominal pain in older children may be the presenting sign or symptom. 4 When such symptoms are present, surgical excision of the dilated segment is recommended as a cure for the condition.…”

Concomitant segmental intestinal dilatation and omphalocele

“…In some cases, a barium study that shows isolated localized intestinal dilation helps to make the diagnosis. 8 There is disagreement about the pathogenesis of SID. Irving and Lister, in explaining a correlation between SID and omphalocele, suggested that temporary extrinsic compression and bowel entrapment could lead to SID.…”

“…1 Some authors have called SID a giant Meckel diverticulum because the two entities have several similar characteristics. 8 SID may contain heterotopic gastric or pancreatic tissue and is commonly located in the ileum, although any sites throughout the digestive tract may be involved. Furthermore, an apparent feeding vessel to SID originating from the mesentery resembles the vitelline vessel seen with the Meckel diverticulum.…”

Segmental dilatation of ileum: an unusual cause of severe malnutrition

“…Segmental dilatation of the ileum is an unusual condition, and a review of the literature revealed that a large proportion (45%) of all the reported patients (n=53) with segmental dilatation of ileum were neonates [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. The rest were distributed among the infant and children (32%) and adult (23%) age groups.…”

“…It has also been called idiopathic localized dilatation of the ileum, ileal dysgenesis, segmental mega-ileum, and giant Meckel's diverticulum [1]. The caliber of the bowel lumen increases locally without luminal obstruction or thickening of the bowel wall.…”