Radiologic features of the jejunum in hypoalbuminemia

Although hypoalbuminemia is a recognized cause of jejunal dilatation, the level of serum albumin at which this occurs and its relation to the extent of jejunal dilatation in celiac disease have not been clearly established. Barium follow-through examination was performed in 12 patients with hypoalbuminemia, in 21 patients with celiac disease, some of whom had a reduced serum albumin, and in 14 control subjects. Jejunal width was increased in patients with hypoalbuminemia and there was a highly significant correlation between jejunal width and the level of serum albumin (p less than 0.001). The level of serum albumin at which jejunal dilatation occurred ("albumin threshold") was found to be 27 g/l. Hypoalbuminemia was not found to be an important factor in the jenunal dilatation of celiac disease. There was a close correlation between the presence of edema and ascites and radiologic abnormality in the jejunum, suggesting that these appearances in nephrotic syndrome are due to intestinal edema. This study suggests that the serum albumin should be taken into account when interpreting the caliber of the small intestine.