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Usefulness of Magnetic Resonance Enterography in Diagnosis of Crohn's Disease

100%
Gmerek Ł., Katulska K., Horbacka K., Krokowicz P.
Polish Journal of Surgery
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2011
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vol. 83
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issue 5
244-249
EN
The numbers of patients with diagnosed Crohn's disease in Poland continue to be on the rise. It may be assumed that it is associated not with an increased incidence but with significant advancements in diagnostic techniques which in an increasingly better manner solve problems of abdominal pain. One of such methods is magnetic resonance enterography, which gives high hope in the diagnostics of Crohn's disease.The aim of the study was the evaluation of the results of magnetic resonance enterography (MREG) and their comparison with the results of histopathological examination o perioperative specimens.Material and methods. The clinical material comprised 48 patients with suspected Crohn's disease. Colonoscopy was performed in all the patients, followed by magnetic resonance enterography, which evaluated the lesion localisation, large intestine wall thickening, small intestine stenosis, mesenteric vessel proliferation, infiltration of surrounding adipose tissue, lymph node enlargement, presence of enteroenteral, enterovesical and enterocutaneous fistulas. Next, a surgical procedure was performed, with collection of specimen for histopathology. The examination results were compared with those of magnetic resonance enterography.Results. MREG was performed in 48 individuals. Suspected Crohn's disease based on the above examination was diagnosed in 35 cases, isolated small intestine inflammation - in 5, and fibrosis in the remaining 5 patients. No significant differences were found between the lesion localisation done by MREG or perioperativelly. Crohn's disease was confirmed by histopathology in 36 cases. The sensitivity of MREG with histopathology was 91.6%, and the specificity - 77.8%.Conclusions. Magnetic resonance enterography is a highly effective and sensitice method in the diagnostics of Crohn's disease, free of adverse effects and possible to be performed even in pregnant female patients.
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Usefulness of Magnetic Resonance Imaging in Diagnosis and Monitoring of Treatment of Perianal Fistulas

76%
Katulska K., Wykrętowicz M., Stajgis P., Krokowicz Ł., Banasiewicz T., Stajgis M.
Polish Journal of Surgery
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2015
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vol. 86
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issue 8
383-390
3
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Assessment of the Results of Surgical Treatment of Zenker’S Diverticulum in Own Material

64%
Bobkiewicz A., Banasiewicz T., Krokowicz Ł., Dryjas A., Wykrętowicz M., Katulska K., Borejsza-Wysocki M., Malinger S., Drews M.
Polish Journal of Surgery
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2015
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vol. 87
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issue 3
109-115
EN
Zenker diverticulum (ZD) is the most common type of diverticula of the esophagus. Most often refers to men with a peak incidence in the seventh and eighth decade of life. In the majority diverticula remains asymptomatic and in patients with symptomatic course of the disease symptoms are often nonspecific. Aim of the study was to present the authors’ own experience in surgical treatment of Zenker diverticulum. Material and methods. In this paper we present an analysis of 31 patients with confirmed ZD treated surgically at the Clinic in 2004-2014. Patients were analyzed in terms of age, gender, clinical symptoms, diverticulum size, type of surgery, the time to return to the oral intake, hospital stay and perioperative complications. Results. 22 men and 9 women were enrolled it this study. The mean age of the patients was 64.8 (SD, 10.7; in the range of 28 to 82 years). 29 patients (93.5%) underwent resection of the diverticulum, while diverticulopexy was performed in two patients. In 25 (80.6%) cases stapler device was used, while in 4 (12.9%) resection was performed manually. The average size of resected diverticulum was 4.9 cm (SD, 1.5). Following the surgery in four patients (12.9%) complications were present. The average operating time was 118.7 minutes (SD, 42.2, in the range of 50 to 240 minutes). The mean length of hospital stay was 9.3 (SD, 3.3). Conclusions. Surgical treatment of ZD is associated with high effectiveness and low recurrence rate. Despite the advantages of endoscopic techniques, surgical treatment is characterized by one- stage procedure. The use of mechanical suture (stapler) significantly improves the operation, although on the basis of our own analysis there was no superiority revealed over hand sewn. Unquestionable adventage of classical technique is the opportunity to histopathological evaluation of resected diverticulum what is impossible to achieve in endoscopic techniques.
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