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E5226. The Alphabet According to the Duodenum: Pathologies from A to Z: Part II
Authors
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Yashant Aswani;
University of Iowa Hospitals and Clinics
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Karan Rao;
University of Iowa Hospitals and Clinics
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Sarah Averill;
University of Iowa Hospitals and Clinics
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Malak Itani;
University of Iowa Hospitals and Clinics
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Rostislav Ranguelov;
University of Iowa Hospitals and Clinics
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Mason Vaillancourt;
University of Iowa Hospitals and Clinics
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Mohammad Ansari;
University of Iowa Hospitals and Clinics
Background
Relative to intraabdominal organs such as the liver, gallbladder, spleen, stomach, and colon, there are few articles and abstracts that comprehensively describe imaging pathology of the duodenum.
Educational Goals / Teaching Points
The goal of this online educational exhibit is to highlight duodenal pathologies, across multiple imaging modalities such as CT, MRI, ultrasound, fluoroscopy, and MR cholangiopancreatography. In this part 2 of the exhibit, we present duodenal pathologies starting with letters N–Z that cover developmental, inflammatory, infectious, traumatic, and neoplastic pathology. After reviewing this exhibit, radiologists and those in training will be able to understand pathophysiology and clinical significance of duodenal pathologies starting with letters N–Z, recognize key imaging findings of duodenal pathologies across multiple imaging modalities, and summarize pathologies of the duodenum.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
N = Neoplasia both benign (hamartoma, lipoma, etc.) and malignant (adenocarcinoma, carcinoid and neuroendocrine, sarcoma, metastases, etc.). O = Obstruction (internal hernia, other mechanical obstruction), operative procedures (duodenal switch, pancreatic transplant, cholecystoduodenostomy, cystoduodenostomy). P = Polyps and polyposis syndrome (FAP, Peutz Jeghers, etc.), PDA pseudoaneurysm, pneumatosis (benign and life-threatening). Q = Quiescent and active Crohn’s. R = rupture. S = SMA syndrome, situs inversus. T = Trauma. U = Ulcer disease (H. pylori, NSAIDs, steroids, cystic fibrosis, sickle cell). V = Varices. W = Windsock sign, Whipple’s disease. X = X-ray (double bubble sign) and fluoroscopic diagnoses. Y = yeast infection. Z = Zollinger Ellison syndrome.
Conclusion
Radiologists should be familiar with the broad range of conditions that can affect the duodenum, an often-overlooked segment of the bowel. This educational exhibit aims to highlight multimodality imaging for recognition of duodenal pathologies. Recognizing and understanding duodenal pathologies will improve patient diagnoses and management.
