Ultrasonographic Appearance and Etiology of Corrugated Small Intestine

Abstract

An ultrasound pattern of corrugated, and sometimes thickened, bowel wall has been associated with pancreatitis and small intestinal lymphangiectasia. In a retrospective study, records of dogs and cats with an ultrasound diagnosis of corrugated bowel were examined for age, breed, gender, presenting complaint, abdominal radiographic results, and final diagnosis. Eighteen dogs and six cats had an ultrasound diagnosis of corrugated bowel. The final diagnosis was pancreatitis (12 of 24), peritonitis (4 of 24), enteritis (2 of 24), pancreatic neoplasia (2 of 24), diffuse abdominal neoplasia (1 of 24), lymphocytic-plasmacytic enteritis (1 of 24), thrombosis/infarction (1 of 24), and protein-losing enteropathy and acute renal failure (1 of 24). The presence of bowel wall corrugation, although a nonspecific finding, should alert one-to the possibility of pancreatitis, enteritis, peritonitis, neoplasia, or bowel wall ischemia.

Qualitative and Quantitative Contrast Enhanced Ultrasonography of the Pancreas Using Bolus Injection and Continuous Infusion Methods in Normal Dogs

“…Therefore, the duodenum could be used as an internal control when investigating CEUS pattern of the pancreas. However, it is important to remember that diseases of the pancreas, such as pancreatitis, may affect the surrounding organs including the duodenum [18]. …”

Pancreas

“…The pancreaticoduodenal vein (arrowhead) is seen in cross section between the pancreas and the duodenum (D). 38 The stomach is usually empty if the animal has been vomiting. Multifocal hypoechoic areas, cystlike lesions, hyperechoic regions, and mixed patterns of echogenicity are commonly identified with canine pancreatitis.…”

“…38 However, the final diagnosis must be confirmed in another manner because gastroenteritis, diffuse neoplastic infiltration of the stomach and bowel, septic peritonitis, and other conditions can produce secondary findings similar to pancreatitis. Functional ileus with fluid distention and thickening of the adjoining wall of the duodenum or stomach or free peritoneal fluid in the pancreatic region suggests pancreatitis.…”

Gastrointestinal Tract

“…28,64 The bowel wall is sometimes thickened as well as corrugated. This pattern has been defined as an undulating or rippled wall, best visualized by noting the undulating hyperechoic line of the mucosa/lumen interface, the submucosa, or both.…”

“…28,64 The bowel wall is sometimes thickened as well as corrugated. 64,68 Although abnormal, this pattern is a nonspecific finding that could be caused by any of the previously listed conditions. 67 Other etiologies of so-called corrugated bowel include enteritis, peritonitis (Figure 12-27, B), neoplasia, and bowel wall ischemia.…”