Figure 1
Widened duodenal sweep
Barium meal demonstrates widened duodenal sweep, loss of the normal duodenal mucosal pattern, and flattening of the medial wall of the first to third parts of the duodenum.
Clinical History
45 year old female presents with several months of upper abdominal pain. She had a single episode of acute gallstone induced pancreatitis several years ago. She was investigated with an upper GI series as well as a CT abdomen.
Imaging Findings
45 year old female presents with several months of upper abdominal pain. She had a single episode of acute gallstone induced pancreatitis several years ago. She was investigated with an upper GI series as well as a CT abdomen.
Discussion
There can be a great variation in the duodenal sweep in normal patients. True duodenal sweep widening is usually due to pancreatic disease. This can be benign, such as pancreatic pseudocysts, or malignant. These are often indistinguishable purely on barium studies and additional cross sectional imaging, such as CT, is required. Other causes of duodenal sweep widening include pancreatico-duodenal adenopathy, retroperitoneal masses (primary or metastatic tumors), choledochal cyst or mesenteric cystic lymphangioma.
Differential Diagnosis List
Widened duodenal sweep secondary to pancreatic pseudocyst.
Final Diagnosis
Widened duodenal sweep secondary to pancreatic pseudocyst.
References
[1]
Eisenberg RL, Levine MS.
Miscellaneous abnormalities of the stomach and duodenum.
In Gore RM, Levine MS (ed) Textbook of gastrointestinal radiology.
WB Saunders, Philadelphia, pp 670-671 (2000).
Case information
| URL: | https://www.eurorad.org/case/774 |
| DOI: | 10.1594/EURORAD/CASE.774 |
| ISSN: | 1563-4086 |
Figure 2
Widened duodenal sweep by pancreatic pseudocyst
Contrast enhanced CT demonstrates a 3 x 4cm pseudocyst arising from the anterior aspect of the pancreatic head which is causing distortion of the adjacent duodenum.
Widened duodenal sweep
Barium meal demonstrates widened duodenal sweep, loss of the normal duodenal mucosal pattern, and flattening of the medial wall of the first to third parts of the duodenum.
Widened duodenal sweep by pancreatic pseudocyst
Contrast enhanced CT demonstrates a 3 x 4cm pseudocyst arising from the anterior aspect of the pancreatic head which is causing distortion of the adjacent duodenum.