Scleroderma - small bowel involvement
Citation, DOI, disclosures and case data
At the time the case was submitted for publication Andrew Dixon had no recorded disclosures.
View Andrew Dixon's current disclosuresPresentation
Long standing abdominal bloating and malabsorption.
Patient Data



Barium follow-through of the small bowel demonstrates generalized bowel dilatation with closely approximated valvulae conniventes which are of normal thickness despite dilatation of the bowel lumen.
No strictures / stenoses or masses are visible and the mucosa is otherwise normal.
5 case questions available
Q: What is the appearance of the closely spaced valvulae conniventes known as? show answer
A: Hidebound appearance or stack of coins appearance.
Q: What are two possible diagnoses? show answer
A: Scleroderma, coeliac sprue.
Q: Hidebound appearance is a term which should only be used with one of these diagnoses. Which one? show answer
A: Scleroderma. Although the appearance is similar in coeliac sprue, the term hidebound should be reserved for scleroderma. Stack of coins appearance on the other hand can be used for both.
Q: Which of these two conditions typically affects multiple systems? show answer
A: Scleroderma (which this patient is known to have)
Q: Which gastrointestinal site is most commonly involved in scleroderma? show answer
A: Oesophagus.
Case Discussion
This patient had known long standing scleroderma and demonstrates characteristic small bowel follow-though appearances.
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