• Skip to main content
  • Skip to header right navigation
  • Skip to site footer

Log in
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
www.sages.org

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Awards
    • Who Is SAGES?
    • Leadership
    • Our Mission
    • Advocacy
    • Committees
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Committee Rosters
      • SAGES Past Presidents
  • Meetings
    • SAGES NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2026 Scientific Session Call for Abstracts
      • 2026 Emerging Technology Call for Abstracts
    • CME Claim Form
    • SAGES Past, Present, Future, and Related Meeting Information
    • SAGES Related Meetings & Events Calendar
  • Join SAGES!
    • Membership Application
    • Membership Benefits
    • Membership Types
      • Requirements and Applications for Active Membership in SAGES
      • Requirements and Applications for Affiliate Membership in SAGES
      • Requirements and Applications for Associate Active Membership in SAGES
      • Requirements and Applications for Candidate Membership in SAGES
      • Requirements and Applications for International Membership in SAGES
      • Requirements for Medical Student Membership
    • Member Spotlight
    • Give the Gift of SAGES Membership
  • Patients
    • Join the SAGES Patient Partner Network (PPN)
    • Patient Information Brochures
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find A SAGES Surgeon
  • Publications
    • Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Sustainability in Surgical Practice
    • SAGES Stories Podcast
    • Patient Information Brochures
    • Patient Information From SAGES
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • MesSAGES – The SAGES Newsletter
    • COVID-19 Archive
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • Avoid Opiates After Surgery
    • SAGES Subscription Catalog
    • SAGES TV: Home of SAGES Surgical Videos
    • The SAGES Safe Cholecystectomy Program
    • Masters Program
    • Resident and Fellow Opportunities
      • MIS Fellows Course
      • SAGES Robotics Residents and Fellows Courses
      • SAGES Free Resident Webinar Series
      • Fluorescence-Guided Surgery Course for Fellows
      • Fellows’ Career Development Course
    • SAGES S.M.A.R.T. Enhanced Recovery Program
    • SAGES @ Cine-Med Products
      • SAGES Top 21 Minimally Invasive Procedures Every Practicing Surgeon Should Know
      • SAGES Pearls Step-by-Step
      • SAGES Flexible Endoscopy 101
    • SAGES OR SAFETY Video Activity
  • Opportunities
    • Fellowship Recognition Opportunities
    • SAGES Advanced Flexible Endoscopy Area of Concentrated Training (ACT) SEAL
    • Multi-Society Foregut Fellowship Certification
    • Research Opportunities
    • FLS
    • FES
    • FUSE
    • Jobs Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • OWLS/FLS
You are here: Home / Abstracts / Magnetic Resonance Enterography: Test of Choice in Diagnosing Intestinal \’Zebras\’

Magnetic Resonance Enterography: Test of Choice in Diagnosing Intestinal \’Zebras\’

Reid C Vegeler, MD, Anjali S Kumar, MD MPH. Section of Colorectal Surgery, Department of Surgery, Washington Hospital Center

Introduction: Small bowel tumors and other rare intestinal disorders are often exceedingly difficult to identify. Even cutting-edge technologies such as push enteroscopy and capsule endoscopy can fail to determine the cause of a patient’s symptoms. Magnetic resonance enterography (MRE) has become an increasingly reliable tool in the difficult-to-diagnose or difficult-to-monitor patient. At our institution, the use of MRE can replace capsule endoscopy or be utilized when traditional endoscopy and imaging fails.

Methods: We present a retrospective case series of three rare intestinal disorders from a prospectively collected database of 83 MREs in 66 patients. Patient #1 had a history of prolonged crampy abdominal pain and melena. Patient #2 was an HIV patient with a six-month history of rectal pain and new onset of mucousy stools. Patient #3 had been undergoing surveillance enteroscopies for a known diagnosis of Peutz-Jeghers syndrome.

Interventions and Results: MRE was performed after oral intake of water with psyllium fiber supplement. IV glucagon was used to eliminate bowel peristalsis and IV gadolinium was used for contrast after which pulse sequences were obtained. Patient #1 had abdominal pain and weight loss exceeding 22kgs within a six-month period. After CT scan showed only bowel wall thickening and mesenteric stranding, colonoscopy and push enteroscopy failed to find a source. However, by MRE, a 3 cm carcinoid tumor in the mesentery was diagnosed. Patient #2 underwent three lower endoscopies that showed non-specific inflammation. Ultimately, MRE demonstrated a rectal lymphoma which extended into the mesorectal fascia. Patient #3 underwent an MRE after developing anemia. The patient’s semiannual enteroscopies and flexible sigmoidoscopies had failed to demonstrate any new polyps, while a MRE found 7 small bowel polyps in the jejunum and ileum, the largest measuring 25mm and the smallest <10mm.

MRE with clearer delinieation of small bowel mesentery carcinoid Patient 2 Patient 3

Patient #1 MRE Patient #2 MRE Patient #3 MRE

Conclusion: We demonstrate that MRE is a useful diagnostic modality in patients whose surveillance is difficult or to diagnose rare colorectal disease phenomena, colloquially referred to as “zebras”.


Session: Poster
Program Number: P155
View Poster

957

Share this:

  • Click to share on X (Opens in new window) X
  • Click to share on Facebook (Opens in new window) Facebook
  • Click to share on LinkedIn (Opens in new window) LinkedIn
  • Click to share on Pinterest (Opens in new window) Pinterest
  • Click to share on WhatsApp (Opens in new window) WhatsApp
  • Click to share on Reddit (Opens in new window) Reddit
  • Click to share on Pocket (Opens in new window) Pocket
  • Click to share on Mastodon (Opens in new window) Mastodon
  • Click to share on Threads (Opens in new window) Threads
  • Click to share on Bluesky (Opens in new window) Bluesky

Related


sages_adbutler_leaderboard

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064

1-310-437-0544

[email protected]

Monday – Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Bluesky
  • X
  • Instagram
  • Facebook
  • YouTube

Copyright © 2025 · SAGES · All Rights Reserved

Important Links

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals