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Radiology and adult celiac disease Current indications of small bowel barium examinations La Seta F; Buccellato A; Albanese M; Barbiera F; Cottone M; Oliva L; Agricola A; Costanzo GS; Lagalla RRadiol Med 2004[Nov]; 108 (5-6): 515-21PURPOSE: To evaluate the current role of small bowel (SB) radiologic barium examinations in adult celiac disease (ACD). MATERIALS AND METHODS: Retrospective review of 61 SB barium examinations in 280 ACD patients. Sixty-one examinations in 61 patients were performed: 7/61 with small bowel ''follow-through'' (SBFT) method, and 54/61 with small bowel double-contrast enteroclysis (SBE). Radiological criteria for ACD diagnosis were divided in four groups: 1) definite ACD (reversal of jejuno-ileal fold pattern); 2) possible ACD (malabsorption pattern and ileal jejunization); 3) malabsorption (fluid, dilatation, ''moulage'', flocculation); 4) complicated ACD (irregular, thickened, nodular folds; wall thickening; masses). RESULTS: In 49/61 patients RX examinations were performed before ACD diagnosis. In this group, clinical presentations included one or more of the following: diarrhea, weight loss, malabsorption, anemia, abdominal pain; 7/49 had a SBFT, and 42/49 a SBE. All 7 SBFTs showed pattern 3, and 8/42 SBEs showed pattern 2 (suspected ACD). In 34/42 patients SBE allowed a definite ACD diagnosis (pattern 1); however, 6/34 were also false-positive for complicated ACD (pattern 4). Ten out of sixty-one patients were clinically suspected of having complicated ACD, correctly excluded (8/8) or confirmed (2/2) by SBE. None of these 59/61 patients had a radiologic diagnosis of normal' SB. The last 2/61 patients with ACD, examined for persisting chronic anemia, had a normal SBE. CONCLUSIONS: This study confirm that SB radiology may be of value either in ACD diagnosis or in excluding complications: SBE is currently the most accurate examination. SBE alone is however less accurate in confirming complicated ACD; further imaging techniques are always needed in this clinical context.|*Barium Sulfate[MESH]|*Contrast Media[MESH]|*Enema[MESH]|Adolescent[MESH]|Adult[MESH]|Aged[MESH]|Celiac Disease/complications/diagnosis/*diagnostic imaging[MESH]|Diagnosis, Differential[MESH]|Female[MESH]|Humans[MESH]|Intestine, Small/*diagnostic imaging[MESH]|Male[MESH]|Middle Aged[MESH]|Radiography[MESH]|Retrospective Studies[MESH] |
