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

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