Approach to the differential diagnosis of inflammatory bowel disease:
- Crohn disease
—- Transmural inflammation of bowel
—- Involves any part of gastrointestinal tract in a non-contiguous manner (skip lesions) but classically involves small bowel
—- Complications include small bowel strictures and penetrating fistula which can lead to abscess - Ulcerative colitis
—- Mucosal and submucosal inflammation of bowel
—- Involves colon in a contiguous manner from the rectum retrograde in the colon, may rarely involve terminal ileum
—- Complications include loss of haustral markings (lead pipe sign), colonic shortening and narrowing - Lymphoid hyperplasia is a normal finding of pseudopolyps in the terminal ileum seen on a small bowel follow through exam and should not be confused with early inflammatory changes from inflammatory bowel disease
Pediatric Imaging 