This document discusses various medical conditions that can cause small bowel dilatation visible on imaging, including postsurgical changes from a Billroth-II procedure, idiopathic sprue with hypersecretion, scleroderma showing a "hidebound pattern", lactase deficiency visible after lactose ingestion, systemic lupus erythematosus, and amyloidosis. Figures are provided as examples for each condition.

1. 24Small Bowel Dilatation

2. CLINICAL IMAGAGING
AN ATLAS OF DIFFERENTIAL DAIGNOSIS
EISENBERG
DR. Muhammad Bin Zulfiqar
PGR-FCPS III SIMS/SHL

3. • Fig GI 24-1 Surgical vagotomy with partial
gastrectomy and Billroth-II anastomosis.

4. • Fig GI 24-2 Idiopathic (nontropical) sprue.
Note the pronounced hypersecretion.

5. Fig GI 24-3 Scleroderma. For the degree of dilatation, the small
bowel folds are packed remarkably close together (hidebound
pattern).

6. • Fig GI 24-4 Lactase deficiency. (A) Normal
conventional small bowel examination. (B)
After the addition of 50 g of lactose to the
barium mixture, there is marked dilatation of
the small bowel with dilution of barium, rapid
transit, and reproduction of symptoms.

7. • Fig GI 24-5 Systemic lupus erythematosus.

8. • Fig GI 24-6 Amyloidosis.