What is the appearance of the closely spaced valvulae conniventes known as?
Hidebound appearance or stack of coins appearance.
What are two possible diagnoses?
Scleroderma, coeliac sprue.
Hidebound appearance is a term which should only be used with one of these diagnoses. Which one?
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.
Which of these two conditions typically affects multiple systems?
Scleroderma (which this patient is known to have)
Which gastrointestinal site is most commonly involved in scleroderma?
Barium follow-through of the small bowel demonstrates generalised 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.