Duodenal imaging on the spotlight: from A to Z

Abdominal computed tomography (CT) is frequently performed to evaluate gastrointestinal pathologic conditions. The majority of the gastrointestinal radiology literature has concentrated on the colon, stomach, and distal small bowel. The duodenum is often overlooked on imaging, namely on CT, but its anatomy (intra and retroperitoneal) and location in such close proximity to other viscera results in involvement by a multitude of primary and secondary processes, some of them exclusive to this bowel segment. While some conditions, like duplications, lipomas, and diverticula, are usually asymptomatic and are incidentalomas that have no pathologic significance, others are symptomatic and very relevant and should be recognized by every general radiologist: development conditions such as annular pancreas and gut malrotation; inflammatory processes such as ulcers and secondary involvement from pancreatitis; neoplastic conditions such as adenocarcinoma, lymphoma, or local extension from adjacent malignancies. They all can be reliably diagnosed with CT. In this article, we demonstrate the typical imaging features of various diseases involving the duodenum, such as developmental, traumatic, inflammatory, infectious, neoplastic, and postsurgical pathologic conditions in alphabetical order, focusing mainly on upper gastrointestinal series (UGIS) and CT but also some radiography, ultrasound, and magnetic resonance (MR) imaging.

Pediatric Gastrointestinal Radiology

Chapter 12 examines radiologic images for common and uncommon pediatric gastrointestinal disorders. These include neonatal high bowel obstructions such as midgut malrotation and volvulus, duodenal atresia, duodenal web, annular pancreas, and pyloric stenosis. The chapter goes on to look at neonatal low bowel obstruction, including ileal disease such as ileal atresia and meconium ileus and colonic disease such as Hirschsprung disease and meconium plug. We then look at causes of pediatric bowel obstruction in older patients, such as intussusception, appendicitis, enteric duplication cysts, and inguinal hernia. Additional neonatal disorders discussed include necrotizing enterocolitis, and meconium peritonitis. Diseases of the pancreas examined include cystic fibrosis and pancreatitis. Liver tumors reviewed are infantile hepatic hemangioma and hepatoblastoma. Diseases of the biliary system looked at include choledochal cysts and biliary cysts, and biliary atresia. Splenic abnormalities examined include polysplenia and asplenia, heterotaxy syndromes, and sickle cell disease.