Infectious ileocecitis

Puylaert JB, Van der Zant FM, Mutsaers JA (1997) Infectious ileocecitis caused by Yersinia, Campylobacter, and Salmonella clinical, radiological and US findings. Eur Radiol 7 3-9... 

Infectious ileocecitis is an infection of the terminal ileum and caecum that is caused by Yersinia entero-colitica, Campylobacter jejuni or Salmonella enter-itidis. The clinical features of infectious ileocecitis are very similar to those commonly found in acute appendicitis, with localized pain in the right lower quadrant being the main symptom, whereas diarrhoea is absent or mild. Local tenderness maybe less prominent and acute phase reactants more elevated than in appendicitis. Due to these symptoms, infec-... 

It has been widely shown that ultrasound may reveal a high incidence of infectious ileocecitis in patients with acute right lower quadrant pain suspicious for appendicitis (Puylaert et al. 1988, 1989, 1997 Tarantino et al. 2003). Sonography may also reveal the features of the bowel wall useful in the differential diagnosis between infectious ileocolitis, Crohn s disease and appendicitis (Table 11.1). 

According to Puylaert et al. (1997) the sonographic involvement of the terminal ileum, caecum, ascending colon and mesenteric lymph nodes in infectious ileocecitis caused by different microorganisms may be different, thus suggesting a possible aetiological diagnosis. 

In the differential diagnosis between infectious ileocecitis and Crohn s disease, the latter is characterized by transmural inflammation and intestinal com-... 

Table 11.1. Main differences in sonographic features of infectious ileocecitis caused by Yersinia, Campylobacter or Salmonella, Crohn s disease and appendicitis...

Fig. 11.4a-c. Infectious ileocecitis in a 20-year-old male with clinical signs of appendicitis, a Ultrasound showed marked wall thickening of ileum confined to mucosa and submucosa, b Marked thickening of the caecal wall mainly confined to submucosa (sm). c Wall thickening of the ascending colon... 

Fig. 11.5a,b. Sagittal view of caecum, ileocaecal valve and ascending colon (a), and axial view of the ileum ileocaecal valve and caecum (b) are the most typical US features of infectious ileocecitis... 

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