Pattern Approach for Diseases of Mesenteric Small Bowel on Barium Studies

Abstract

Despite an array of sophisticated imaging techniques, the barium examination remains a valuable diagnostic test for evaluating structural abnormalities of the small bowel. Most patients can be examined with conventional small-bowel follow-through studies, in which periodic imaging of the entire small bowel is performed by using fluoroscopic guidance; however, some patients may benefit from enteroclysis, in which contrast agents are instilled into the small bowel via a catheter placed in the proximal jejunum for optimal distention and better depiction of individual small-bowel loops. This review for residents discusses the major diseases involving the mesenteric small bowel and presents a pattern approach for the wide spectrum of abnormalities found on barium studies, including polypoid lesions, cavitated lesions, annular lesions, outpouchings, separation of loops, abnormal folds, nodules without abnormal folds, and dilated small bowel.

Radiologic manifestations of angioedema

“…9 and 11). This finding has also been likened to a stack of coins on barium studies because of the uniformly thickened folds with a relatively parallel arrangement [23] (Fig. 11).…”

“…Differential diagnoses of gastrointestinal angioedema consist of other pathologies that may cause bowel wall oedema, including ischaemia, vasculitis, and hypoproteinaemia [7, 23]. Since there are numerous entities that may present as mural stratification or the halo sign, the diagnostic approach is based on the exclusion of other potential causes clinically and radiologically.…”

Giant Diverticulum of the Duodenum

“…In enteroclysis, a contrast agent is instilled into the small bowel via a gastroduodenal catheter which is placed just beyond the ligamentum of Treitz. In this way, greater luminal distention and better depiction of the individual small bowel loops is reached [13]. …”

Abdominal manifestations of histiocytic disorders in adults: imaging perspective

“…45 Barium studies reveal nodular, thickened and irregular folds, predominantly in the jejunum and, to a lesser degree, in the ileum (Figure 10). 47 Cross-sectional imaging demonstrates low-attenuation Figure 9. Imaging spectrum of mycobacterium avium complex infection in three different patients: (a) contrast-enhanced axial CT image demonstrating small periaortic necrotic lymph nodes (white arrows); (b) multiple hypodense hepatic lesions (white arrows) and splenic lesions (black arrows) are seen in contrast-enhanced axial CT; and (c) diffuse mass-like wall thickening involving the duodenum causing partial obstruction (black arrows) is seen on the small bowel follow-through barium examination.…”