Radiologic manifestations of malabsorption: a nonspecific finding

Children demonstrating a radiologic malabsorption pattern on small bowel follow-through study performed for other reasons are frequently subjected to intensive gastrointestinal investigations, even in the absence of clinical manifestations of malabsorption. To determine the usefulness of this radiologic finding, the clinical findings of all patients with the typical malabsorption pattern on small bowel follow-through examination were reviewed retrospectively. The presence of a malabsorption pattern was based on three radiologic criteria: flocculation and segmentation of barium, thickening of mucosal folds, and dilation of intestinal loops. Thirteen patients fulfilled the criteria for radiologic malabsorption pattern, but six (46%) had no clinical evidence of malabsorption, according to 3- to 5-day fecal fat analysis. In addition, five of these patients had normal mucosal histologic findings on duodenal biopsy. It was concluded that radiologic malabsorption pattern is a nonspecific finding, and in the absence of other clinical features suggestive of malabsorption or growth failure further investigations may not be justified.