Radiographic abnormalities of the duodenum in cystic fibrosis

Radiologically demonstrable abnormalities of the duodenum are common in cystic fibrosis and are most prevalent in the second part of the duodenum. Out of 14 upper gastrointestinal barium studies performed on patients with cystic fibrosis over a period of 10 years, radiographic abnormalities of the duodenum were found in 12, an incidence of 86%. The abnormalities consisted of thickened mucosal folds, nodular indentations and effacement of the normal mucosal pattern. A duodenal stricture that was radiologically similar to a carcinoma presented as pyloric obstruction in one patient and this resolved on medical treatment. We conclude that barium studies in patients with cystic fibrosis may uncover unsuspected abnormalities of the duodenum, that these form part of the syndrome and that invasive treatment is not indicated.