Gastroenterology

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Widened Duodenal C-loop
Duodenal- Mass Effect

  • DDX: normal variant, pancreatitis/pseudocyst, pancreatic mass, LN enlargement of messentery, AAA, choledochal cyst, retroperitoneal mass
  • Spiculation suggest pancreatic cancer vs. chronic pancreatitis
  • the sweep can appear widened in an obese patient

Example of widened c-loop in pancreatic cancer
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Duke DDX Thickened Duodenal Folds

  • Inflammatory – peptic duodentitis(most common cause), ZE, pancreatitis, cholecystitis, Crohn, infective(TB parasites, cryptosporidia in AIDS)
  • Neoplastic
  • Infiltrative – Whipple’s, amyloid, EG
  • Vascular – intramural hematoma, ischemia, varices
  • Edema – hypoproteinemia, portal HTN, CHF

 

Small Bowel
Duke Notes
Normal anatomy
Caliber - < 3cm(allow +1 for enteroclysis)
Wall thickness 1mm
Folds/inch – jejunum 4-7, ileum 2-4

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