Adult celiac disease: US signs

PURPOSE: To examine whether distinct ultrasonographic (US) signs exist in p atients with adult celiac disease. MATERIALS AND METHODS: In a partly retrospective study, abdominal sonograms were obtained in 11 patients with adult celiac disease. Fifty matched cont rol subjects also were examined. After the patients had fasted overnight, t hey were examined with 2-4-MHz abdominal and high-frequency 5-10-MHz linear -array US transducers. RESULTS: The authors found several US pathologic signs in patients with unt reated disease, including abnormal fluid-filled small intestine in all 11 p atients, flaccid and moderately dilated small-bower loops (2.5-3.5 cm)in ei ght, slight diffuse thickening of the small-bower wall (3-5 mm) in seven, i ncreased peristalsis of the small intestine in eight, enlarged mesenteric l ymph nodes (anteroposterior diameter 5-10 mm) in nine, dilated caliber of t he superior mesenteric artery or portal vein in seven, free fluid in the ab dominal cavity in five, and increased echogenicity of the liver in six. Non e of these signs was present in the control group. CONCLUSION: There are several US signs associated with adult celiac disease . None of the signs identified is specific, but a combination of signs is c haracteristic and indicates suspicion of this disease in a high percentage of cases. US could help to avoid diagnostic delay, especially in patients w ho have atypical clinical presentations.