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.
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Long standing abdominal bloating and malabsorption.
Patient Data
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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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