Significance of abnormal gastrointestinal gas in systemic amyloidosis

Nine cases of amyloidosis involving the gastrointestinal tract were reviewed for the presence of abnormal gastrointestinal gas by taking plain roentgenograms of the abdomen (PRA) as a diagnostic adjunct. Findings were compared to data obtained by conventional barium study or endoscopic examination. PRA revealed marked gaseous dilatation of the gastrointestinal tract simulating intestinal obstruction in three cases and a moderate or mild increase of gas in two cases each. Abnormality was thus found in seven of the nine cases by PRA. Conventional barium study by means of upper gastrointestinal series, small bowel series and barium enema showed abnormal findings in five of seven cases. Endoscopic examination of the stomach and distal colon disclosed mucosal abnormality in three of seven cases. The rate of abnormal findings detected by the three methods cannot easily be compared to each other because of the differences in symptoms and treatment of individual patients. Nevertheless, PRA seem to be valuable in demonstrating a high rate of abnormalities in amyloidosis.