The barium-study findings in small intestinal malabsorption include all the following except:
A. Increased bowel transit timeB. Mucosal atrophy
C. Stricture of bowel
D. Flocculation of barium
Ans. C. (stricture of bowel)
Small intestinal malabsorption
There are four racliologic groups of findings in small intestinal malabsorption, related to alteration in:
1. Peristalsis - variable peristalsis is hallmark with hypo and hypertonic segments, overall leading to increased transit
time and segmentation of barium.
However, the transit time may be long/short/normal.
Painless transient intussusception may be seen on fluoroscopy.
2. Caliber - dilatation of segments of bowel coils in 80% cases (>3 cm).
3. Secretions - increased secretions cause dilution of barium and later clumping, segmentation and flocculation of barium.
4. Mucosa - edematous mucosa with thickened valvulae conniventes giving cog-wheel’ pattern (colonization of jejunum), instead of their normal feathery’ pattern; later atrophy occurs and mucosal folds disappear with thinning of bowel wall.
Valvulae conniventes may exhibit five types of appearances:
o Normal
o Squared ends
o Thickening of valvulae
o Reversed jejunoileal pattern
o Absence of valvulae conniventes: “moulage sign” characteristic of sprue
