Small bowel follow-through (SBFT) in a 30-year-old with chronic diarrhoea shows irregular thickening and nodularity of the valvulae conniventes in the jejunum, with prominent 'stacking' of valvulae (moulage sign) and a mosaic mucosal pattern. These findings point to:
- A Coeliac disease (malabsorption) with jejunisation of ileum and ilealisation of jejunum ✓
- B Crohn's disease of the small bowel
- C Carcinoid of the small bowel
- D Whipple's disease
Correct answer: A. Coeliac disease (malabsorption) with jejunisation of ileum and ilealisation of jejunum
Explanation
In coeliac disease, SBFT classically shows reversal of the normal fold pattern — the jejunum shows diminished/absent folds (jejunisation) while the ileum shows increased folds (ilealisation/jejunisation of ileum). The 'moulage sign' refers to smooth featureless small bowel loops resembling moulage (cast) due to absent folds from villous atrophy, combined with dilated loops (flocculation in older barium). Crohn's shows strictures, skip lesions, and rose-thorn ulcers.
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.