UNLABELLED: The goal of this prospective study was to assess non-steroidal anti-inflammatory drug (NSAID)-induced enteropathy in patients with rheumatoid arthritis (RA) or osteoarthritis (OA) by means of non-invasive wireless capsule enteroscopy. A total of 143 patients (74 with RA, 69 with OA) treated with NSAIDs (>1 month) and 42 healthy volunteers were included. All subjects underwent capsule endoscopy, laboratory tests and filled in questionnaires. The severity of small bowel injury was graded as: mild (red spots or sporadic erosions), moderate (10-20 erosions) or severe (>20 erosions or ulcers). Capsule endoscopy identified small bowel lesions in 44.8 % of patients (mild 36.4 %, moderate 3.5 % and severe in 4.9 %). Mild non-specific lesions were found in 11.9 % healthy volunteers. There was a significantly higher prevalence of enteropathy in RA (56.8 %) compared to OA (31.9 %, p < 0.01). A significant difference between NSAID users (RA and OA) with and without enteropathy was observed in erythrocytes (p < 0.01), the leucocyte count (p < 0.05), haemoglobin (p < 0.05), haematocrit (p < 0.05), serum albumin (p < 0.01) and erythrocyte sedimentation rate (p < 0.05). No relationship was found between enteropathy and dyspepsia, gender or age. NSAID therapy is associated with a significant risk of small bowel injury. The risk is significantly higher in RA patients suggesting a possible influence of the underlying disease. TRIAL REGISTRATION NUMBER: DRKS00004940.

• Klíčová slova
• Enteropathy, Non-steroidal anti-inflammatory drug, Osteoarthritis, Rheumatoid arthritis, Small bowel, Wireless capsule endoscopy,
• MeSH
• antiflogistika nesteroidní škodlivé účinky   terapeutické užití   MeSH
• dospělí MeSH
• kapslová endoskopie MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemoci střev chemicky indukované   diagnostické zobrazování   epidemiologie   MeSH
• osteoartróza farmakoterapie   MeSH
• prevalence MeSH
• prospektivní studie MeSH
• průzkumy a dotazníky MeSH
• revmatoidní artritida farmakoterapie   MeSH
• tenké střevo diagnostické zobrazování   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antiflogistika nesteroidní MeSH

INTRODUCTION: The aim of our prospective study was to define endoscopy appearance of the small bowel in healthy volunteers. METHOD: Forty-two healthy volunteers underwent wireless capsule endoscopy, clinical investigation, laboratory tests, and completed a health-status questionnaire. All subjects were available for a 36-month clinical follow-up. RESULTS: Eleven subjects (26%) had fully normal endoscopy findings. Remaining 31 persons (74%), being asymptomatic, with normal laboratory results, had some minor findings at wireless capsule endoscopy. Most of those heterogeneous findings were detected in the small intestine (27/31; 87%), like erosions and/or multiple red spots, diminutive polyps and tiny vascular lesions. During a 36-month clinical follow-up, all these 42 healthy volunteers remained asymptomatic, with fully normal laboratory control. CONCLUSIONS: Significant part of healthy subjects had abnormal findings at wireless capsule endoscopy. These findings had no clinical relevance, as all these persons remained fully asymptomatic during a 36-month follow-up. Such an endoscopic appearance would be previously evaluated as "pathological". This is a principal report alerting that all findings of any control group of wireless capsule endoscopic studies must be evaluated with caution.

• Klíčová slova
• 36-month follow-up, Healthy volunteers, Small bowel, Wireless capsule enteroscopy,
• MeSH
• asymptomatické nemoci MeSH
• bezdrátová technologie MeSH
• dospělí MeSH
• kapslová endoskopie * MeSH
• lidé MeSH
• náhodný nález MeSH
• nemoci střev diagnostické zobrazování   MeSH
• prospektivní studie MeSH
• tenké střevo diagnostické zobrazování   MeSH
• zdraví dobrovolníci pro lékařské studie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Computed tomography (CT) colonography is a well established modality for the examination of symptomatic patients as well as in screening. Recent technical advances in improving image quality by iterative reconstruction contribute to the reduction of the radiation dose which is a major concern in CT imaging. PURPOSE: To evaluate image quality of ultralow-dose submilisievert CT colonography using hybrid iterative reconstruction technique. MATERIAL AND METHODS: Sixteen patients underwent contrast-enhanced CT colonography with standard protocol in supine position and ultralow-dose protocol in prone position. Ultralow-dose datasets were reconstructed with filtered back projection and an advanced hybrid iterative reconstruction technique. Two radiologists independently evaluated 96 colonic segments for image quality in the endoluminal view and axial thin sections. Colonic distension, smoothness of colonic wall and distortion of folds in the endoluminal view, sharpness of colonic wall delineation, perceived image noise, and presence of photon starvation artifact were rated on a five-point scale. Intraluminal noise expressed as standard deviation of Hounsfield density was measured in all segments. RESULTS: The mean radiation dose was 0.42 mSv and 5.48 mSv in prone and supine scans, respectively. All distended segments were rated evaluable in standard dose and ultralow-dose series reconstructed with the iterative reconstruction technique, whereas in 61% segments image quality was rated poor or unacceptable in ultralow-dose series where filtered back projection was used with worst ratings in the rectum and the sigmoid colon. CONCLUSION: This pilot study shows that iterative reconstruction technique is a feasible method to decrease the radiation dose from CT colonography for both positions below 1mSv. Further investigations of larger scale need to be done to clarify, whether such a low radiation dose would influence the detection of polyps.

• Klíčová slova
• Colonography, colon, computed tomography, iterative reconstruction, low-dose, polyp,
• MeSH
• dávka záření * MeSH
• kolonografie počítačovou tomografií metody   MeSH
• kontrastní látky MeSH
• kyseliny trijodbenzoové MeSH
• lidé MeSH
• nemoci střev diagnostické zobrazování   MeSH
• pilotní projekty MeSH
• rentgenový obraz - interpretace počítačová metody   MeSH
• senioři MeSH
• studie proveditelnosti MeSH
• vylepšení rentgenového snímku metody   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• ioversol MeSH Prohlížeč
• kontrastní látky MeSH
• kyseliny trijodbenzoové MeSH

Gastrointestinal bleeding is one of acute abdomen conditions that occur relatively frequently. Most cases can nowadays be managed endoscopically, surgery is rarely required. Approximately 5% of gastrointestinal bleeding cases are cases of so-called obscure gastrointestinal bleeding. The presented massive gastrointestinal bleed case report provides a current view on diagnostic and therapeutic modalities in the context of everyday clinical practice.

• MeSH
• angiografie metody   MeSH
• gastrointestinální krvácení diagnostické zobrazování   chirurgie   MeSH
• hemostáza chirurgická metody   MeSH
• lidé MeSH
• mladý dospělý MeSH
• nemoci střev diagnostické zobrazování   chirurgie   MeSH
• počítačová rentgenová tomografie metody   MeSH
• tenké střevo * MeSH
• Check Tag
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

AIM: To present our experience with the detection of bleeding in the small intestine by means of scintigraphy with in vivo-labelled red blood cells (RBCs) in the period of 1998-2009. MATERIALS AND METHODS: A 12-year prospective study was accomplished with 40 patients (23 men, 17 women, aged 12-91, mean 56 years) who had lower gastrointestinal bleeding (obscure-overt bleeding) and underwent scintigraphy with in vivo-labelled RBCs by means of technetium 99m. The scintigraphy was usually performed after other diagnostic tests had failed to locate the bleeding. RESULTS: A total of 26 patients had a positive scintigraphy with in vivo-labelled RBCs and 14 patients had negative scintigraphy. The final diagnosis was confirmed in 20 of 26 patients with a positive scintigraphy by push enteroscopy (6/20), intraoperative enteroscopy (7/20), surgery (4/20), duodenoscopy (1/20), double-balloon enteroscopy (1/20) and X-ray angiography (1/20). The correct location of the bleeding site was identified by RBC scintigraphy in 15 of 20 (75%) patients with the confirmed source. The locations of the bleeding site identified by scintigraphy and enteroscopy (push, intraoperative) and surgical investigations were highly correlated in patients with a positive scintigraphy within the first 3 h. Eleven of the 20 correctly localized studies and none of the incorrectly localized studies were positive in the dynamic phase of imaging. In 5 patients (all erroneously localized), scintigraphy was positive only at a period longer than 18 h. CONCLUSION: RBC scintigraphy is an effective imaging modality in localizing lower gastrointestinal bleeding in patients for whom other diagnostic tests have failed to locate the bleeding. RBC scintigraphy can be successful in the detection of bleeding sites in the small intestine.

• MeSH
• 99mTc-technecistan sodný * MeSH
• časové faktory MeSH
• dítě MeSH
• dospělí MeSH
• erytrocyty diagnostické zobrazování   MeSH
• gastrointestinální endoskopie MeSH
• gastrointestinální krvácení diagnostické zobrazování   MeSH
• jednofotonová emisní výpočetní tomografie * MeSH
• kolon diagnostické zobrazování   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• nemoci střev diagnostické zobrazování   MeSH
• prospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• tenké střevo diagnostické zobrazování   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• Názvy látek
• 99mTc-technecistan sodný * MeSH

Thanks to increasingly number imaging techniques, sonography is no longer indicated solely for the examination of the parenchymal organs of the abdominal cavity, but also for the small and large intestine. It has an important role in differential diagnosis of pain in the right hypogastrium, particularly when acute appendicitis is suspected. Sonography is also used in patients suspected from acute diverticulitis. Other intestinal wall pathologies can be well identified by sonography though the image is often non-specific, and such lesions are difficult to identify in terms of aetiology. A prominent position has endorectal sonography, an important method used mainly for diagnosis of rectal tumours. Unlike other techniques such as CT, it is useful in assessing tumorous infiltration of each of the intestinal wall layers or even the tumour's perirectal propagation. The method can be also used for examination of patients with perirectal abscesses or fistulae. However, endorectal sonography can be quite painful in this location, which is why in such cases we tend to prefer MR imaging.

• MeSH
• endosonografie MeSH
• lidé MeSH
• nemoci střev diagnostické zobrazování   MeSH
• střeva diagnostické zobrazování   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

The authors discuss five older children where malrotation of the gut was diagnosed. The youngest child was three years old, the oldest 16 years. In three children the malrotation was diagnosed from clinical symptoms and examination by imaging methods, in two it was detected by chance during operation. In the two children where the impaired rotation of the gut was detected on operation, non-rotation was involved. In the remaining three children twice a left side paraduodenal hernia was diagnosed and once an external stenosis of the duodenum by Ladd's bands.

• MeSH
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• nemoci střev diagnostické zobrazování   chirurgie   MeSH
• radiografie MeSH
• střeva diagnostické zobrazování   chirurgie   MeSH
• torzní deformity diagnóza   chirurgie   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Enteroclysis is rightly included to modern diagnostic methods for detecting damage to alimentary canal. It enables to visualize even small morphological changes on the mucous membrane of intestine, to prove fistulas if present and to evaluate functional changes if correctly applied. It significantly contributes to establishing early diagnosis in affections of the intestine and consequent use of adequate therapy. The authors in their communication summarized their experience, obtained in the examination of one hundred patients. They selected a modified procedure of examination according to Herlinger with the use of Prontobarium suspension and methyl cellulose. The application was made with a controlled duodenal probe from the Nicholas Company, introduced by nose. The average duration of one examination was 44 minutes.

• MeSH
• dospělí MeSH
• klyzma MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemoci střev diagnostické zobrazování   MeSH
• radiografie MeSH
• síran barnatý MeSH
• tenké střevo diagnostické zobrazování   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• síran barnatý MeSH

• MeSH
• lidé středního věku MeSH
• lidé MeSH
• methylcelulosa * MeSH
• metody MeSH
• nemoci střev diagnostické zobrazování   MeSH
• radiografie MeSH
• senioři MeSH
• síran barnatý * MeSH
• tenké střevo diagnostické zobrazování   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• methylcelulosa * MeSH
• síran barnatý * MeSH

• MeSH
• aktinomykóza diagnostické zobrazování   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemoci střev diagnostické zobrazování   MeSH
• rentgendiagnostika břicha * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH