Duodenitis: A reliable radiologic diagnosis?
The authors performed a retrospective study of 50 patients with endoscopically diagnosed duodenitis who had undergone double-contrast upper gastrointestinal (GI) examinations. Duodenitis was diagnosed on the original radiographic reports in six of 37 patients (16%) with mild-to-moderate duodenitis, five of 13 patients (38%) with severe duodenitis, and 11 of 50 patients (22%) with all grades of duodenitis on endoscopy. Subsequent analysis of the films revealed one or more radiologic signs of duodenitis (including folds more than 4 mm in thickness, mucosal nodularity, bulbar deformity, and erosions) in 18 of 37 patients (49%) with mild-to-moderate duodenitis, eight of 13 patients (62%) with severe duodenitis, and 26 of 50 patients (52%) with all grades of duodenitis on endoscopy. In a separate part of the study, the authors identified another 20 patients with radiographically diagnosed duodenitis who had undergone endoscopic examinations. Nine of those 20 patients (45%) had duodenitis on endoscopy. Subsequent analysis of the films revealed one or more signs of duodenitis in 17 patients from this group. Nine of the latter patients (53%) had duodenitis on endoscopy. Using established radiologic criteria for duodenitis, our rate of false-positive and false-negative radiologic diagnoses still was about 50%. Thus, the double-contrast upper GI examination is a relatively unreliable technique for diagnosing duodenitis.
Key wordsDuodenitis, diagnosis Duodenum, radiography
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- 2.Myren J. Gastric secretion in duodenitis.Scand J Gastroenterol 1982; 17 (Suppl): 98–101Google Scholar
- 7.Joffe SN. Relevance of duodenitis to non-ulcer dyspepsia and peptic ulceration.Scand J Gastroenterol 1982; 17 (Suppl): 88–97Google Scholar
- 8.Donovan IA, Green G, Dykes PW, Owens C, Clendinnen BG, Alexander-Williams J. The pathophysiology of duodenitis.Gut 1975; 16:395Google Scholar
- 9.Cheli R. What is new about duodenitis?Scand J Gastroenterol 1979; 14 (Suppl):28–30Google Scholar
- 14.Whitehead R. Morphological aspects of duodenitis.Scand J Gastroenterol 1982; 17:80–82Google Scholar
- 15.Kirklin BR. A roentgenologic consideration of duodenitis.Radiology 1929; 12:377–381Google Scholar
- 16.Kirklin BR. Duodenitis and its roentgenologic characteristics.AJR 1934; 31:581–587Google Scholar
- 17.Fraser GM, Pitman RG, Lawrie JH, Smith GMR, Forrest APM, Rhodes J. The significance of the radiological finding of coarse mucosal folds in the duodenum.Lancet 1964; 2:979–982Google Scholar
- 22.Cheli R. Symptoms in chronic non-specific duodenitis.Scand J Gastroenterol 1982; 17 (Suppl): 84–86Google Scholar
- 23.Health and Public Policy Committee, American College of Physicians. Endoscopy in the evaluation of dyspepsia.Ann Intern Med 1985; 102:266–269Google Scholar
- 24.Forrester AW, Joffe SN, Lee FD. The endoscopic and histological features of peptic duodenitis.Scand J Gastroenterol 1979; 14 (Suppl): 18–22Google Scholar
- 26.McCallum RW, Singh D, Wollman J. Endoscopic and histologic correlations of the duodenal bulb: the spectrum of duodenitis.Arch Pathol Lab Med 1979; 103:169–172Google Scholar
- 27.Stevenson GW, Laufer I. Duodenum. In: Laufer I, ed.Double contrast gastrointestinal radiology with endoscopic correation. Philadelphia: WB Saunders, 1979:331–371Google Scholar