Imaging Diagnosis

Table 16.2. Causes for the radiographic pattern of malabsorption in the small bowel. (Modified from Reeder 1993)

Common causes
1. Blind loop syndrome (e.g., duplication, diverticulosis of small bowel, Meckel's diverticulum, small bowel stricture with proximal dilatation, postoperative - gastroileostomy, side-to-side anastomosis)
2. Idiopathic steatorrhea
3. Nutritional deficiency (kwashiorkor, pellagra)
4. Pancreatic disease (insufficiency, chronic pancreatitis,
mucoviscidosis, pancreatic carcinoma)
5. Parasitic diseases (hookworm disease, strongyloidiasis, giardiasis, schistosomiasis japonicum, intestinal capillariasis)
6. Sprue, tropical or nontropical

Uncommon causes
1. Amyloidosis; mediterranean fever
2. Angioneurotic edema or other gastrointestinal allergy
3. Carcinoid syndrome
4. Celiac disease
5. Crohn's disease
6. Diabetes mellitus
7. Disaccharidase deficiency
8. Drug induced (e.g., neomycin)
9. Dysgammaglobulinemia
10. Emotional states; anorexia nervosa
11. Eosinophilic gastroenteritis
12. Fistula (esp. gastrocolic)
13. Heavy chain disease
14. Hepatobiliary disease (biliary cirrhosis)
15. Hypothyroidism; hyperthyroidism; hypoparathyroidism
16. Ischemia (chronic intestinal)
17. Lymphangiectasia (intestinal: Gordon's enteropathy)
18. Lymphoma
19. Mastocytosis
20. Metastases, peritoneal
21. Nephrotic syndrome
22. Postgastrectomy steatorrhea ("dumping")
23. Scleroderma; dermatomyositis
24. Small bowel resection (extensive)
25. Tuberculous peritonitis
26. Whipple's disease
27. Zollinger-Ellison syndrome