"Bubbly" duodenal bulb in celiac disease: radiologic-pathologic correlation

AJR. American Journal of Roentgenology
B JonesJ H Yardley

Abstract

Small (1-4 mm) hexagonal filling defects were found on air-contrast studies of the duodenal bulb in three patients with unresponsive (atypical) celiac disease. Multiple biopsies confirmed both celiac disease and peptic duodenitis. Stimulated acid outputs determined in two patients were in the peptic ulcer range. Cimetidine therapy led to improved absorption in all three patients. Repeat upper gastrointestinal series and endoscopy in one patient showed no evidence of nodularity or peptic duodenitis, indicating that these changes may be reversible. Peptic disease may contribute to nodularity in the duodenal bulb and relative lack of response to a gluten-free diet of some patients with celiac disease. The finding of tiny nodules in the duodenal bulb in a patient with malabsorption should lead to consideration of celiac disease as a primary diagnosis with peptic duodenitis as an aggravating factor.

Citations

Jan 1, 1991·Gastrointestinal Radiology·D MerineT M Bayless
Jan 1, 1990·Gastrointestinal Radiology·W J van RooijP M Pijpers
Jan 1, 1986·Gastrointestinal Radiology·C S MarnG G Ghahremani
Sep 22, 2007·AJR. American Journal of Roentgenology·Francis J ScholzChristopher D Scheirey
Sep 25, 2008·Radiology·Marc S LevineIgor Laufer
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Nov 4, 2009·Scandinavian Journal of Gastroenterology·Arie LevineRon Shaoul
Feb 6, 2017·Abdominal Radiology·Shannon P SheedyJeff L Fidler

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