Objectives

-To describe and illustrate MDCT findings of gastrointestinal manifestations of graft versus host disease in adults.

-To review the different abdominal complications in the peritransplantation period and try to accuracy differential diagnosis combining clinical factors with radiologic findings.

Background

Graft versus host disease (GVHD) is a common complication of hematopoietic stem cell transplantation (HSCT). GVHD is a multisystem disease, and primary target organs are skin, hepatobiliary system and gastrointestinal tract. Gastrointestinal tract is commonly affected by complications of HSCT, which are a major cause of morbidity and morbidity in transplant recipient. Diagnosis of GVHD is challenging because clinical manifestations are non-specific and symptoms overlap to other gastrointestinal complications.

Imaging findings OR Procedure findings

MDCT is the main imaging technique used to diagnostic approach and can help to make an early and accuracy diagnosis. Findings at MDCT include diffuse bowel thickening, mucosal enhancement (halo sign), bowel dilatation and inflammatory changes in mesenteric tissues. Extraintestinal CT findings can also help with diagnosis

The interpretation of radiological findings should be appropriately correlated with clinical data, including preconditioning regimen, time elapsed since transplantation, and thereby narrow the differential diagnosis of other post-transplant complications. . Chemotherapy-associated enterocolitis, neutropenic tiflitis, pseudomembranous colitis and infectious enterocolitis should be considered in the differential diagnosis.

Conclusion

MDCT is a valuable diagnostic tool in GVHD. Radiologic findings, in combination with clinical factors, will help radiologists to develop an accurate diagnosis.

Objectives

• Describe abdominal wall anatomy at MDCT imaging.

• Review epidemiology and clinical data of primary and incisional abdominal hernias

• Illustrate specific hernia sites and their complications at MDCT.

Background

Abdominal wall hernias (AWH) are frequent surgical problem that usually were treated without radiological evaluation. However clinical diagnosis can be challenging in patients with obesity, rare locations or acute complications. MDCT has assumed a major role in diagnosis due it excellent anatomic delineation and assessing AWH complications in emergency room.

Imaging findings OR Procedure findings

Abdominal wall hernias reviewed can be classified in:

1. Ventral abdominal hernias:

- Epigastric

- Umbilical

- Spigelian

- Incisional hernias

- Parastomal hernias

2. Groin hernias

- Inguinal

- Femoral

3. Pelvic abdominal hernias

- Obturator hernia

- Perineal hernia

- Sciatic hernia

4. Lumbar hernias

Conclusion

Abdominal wall hernias are one of the most frequent surgical indications. MDCT is a valuable tool for preoperative evaluation and diagnosing potential complications.