Sprue

• 3 diseases: Celiac Disease of Children, Nontropical sprue and Tropical Sprue

• Celiac disease and Nontropical sprue improve on gluten-free diet

• Tropical sprue improves with antibiotics and folic acid

Imaging

• The hallmark features are: dilatation and dilution, especially in jejunum

          • Segmentation of the barium column occurs because it moves more slowly through areas of excessive fluid and separates from the rest of the column-not commonly seen with newer barium mixtures

          • Fragmentation is an exaggerated example of the irregular stippling of residual barium in the proximal bowel (which is normal)

• Intussusception is not uncommon but is usually not obstructive; sprue has increased risk of ca and lymphoma

• Moulage sign is caused by dilated loop with effaced folds looking like tube into which wax has been poured

 
Spure. There is diffuse dilatation of the small bowel without evidence of infiltration of the wall which would produce more of a "picket-fence" appearance than this "stack-of-coins" appearance. Scleroderma would also be in the differential for this pattern, but the duodenum would frequently be dilated and the valvulae would appear closer together.

Learn more about Diffuse Small Bowel Disease here