Monday, June 18, 2012

Small Bowel Aneurysmal Dilatation Differential Diagnosis

Small bowel aneurysmal dilatation is a common pattern of disease in the small bowel. It consists of a focal segment of dilated small bowel associated with a mass. The mass is typically circumferential. The mnemonic MALL can be used to recall the common diagnoses.

DiseaseNotes
MMalignant GISTLymphadenopathy absent; obstruction common
AAdenocarcinoma of small bowel
LLymphomaLymphadenopathy present; obstruction uncommon
LLeiomyosarcoma

Left Upper Quadrant Small Jejunal Aneurysmal Dilatation
Source: Radiology Assistant
Metastatic disease can also present with small bowel aneurysmal dilatation. The most common primary is melanoma, followed by lung, breast, and colon cancer. Metastases tend to be multifocal and necrotic.