Abnormalities in the shape of the duodenal loop on X-ray. Associated with idiopathic antral hypomotility?

We aimed to determine if abnormalities in the shape of the duodenal loop would be useful in identifying patients with gastroduodenal dysmotility. Retrospectively, 126 consecutive patients with suspected functional abdominal symptoms who underwent upper gastrointestinal barium x-ray studies and gastrointestinal manometry were independently evaluated. Twenty-seven patients (21%) had an abnormally shaped duodenal loop (two proximal and 25 distal) by x-ray. An abnormal duodenal loop was associated with female gender but the presenting symptoms were similar in patients with normal and abnormal loops. Antral hypomotility was significantly more common in patients with distal duodenal malrotations compared to those with a normal x-ray (56% vs 27%, P < 0.01); intestinal dysmotility was not associated with the shape of the duodenal loop. The presence of an abnormally shaped duodenal loop in patients presenting with functional gastrointestinal symptoms may be a useful marker for idiopathic antral hypomotility.