GI Radiology > Small Bowel > Disease Patterns > Multiple Filling Defects

Disease Patterns

Multiple Filling Defects: Causes

Tiny nodules

  • Normal Folds
    • Lymphoid hyperplasia presents as multiple tiny (2-4mm) nodules and is associated with giardiasis or immunoglobulin deficiency.
  • Thickened folds
    • Lymphangiectasia
    • Whipple's disease
    • Mastocytosis
    • Waldenstrom's macroglobulinemia
    • Infection (Yersinia, MAI, histoplasmosis)

Benign neoplasms

  • Leiomyomas
  • Carcinoid tumors
  • Hemangiomas
  • Neurofibromas
  • Lipomas (in lipomatosis)
  • Polyposis syndromes

Malignant neoplasms

  • Metastases may present with multiple, discrete mural masses with variability of size.
  • Lymphoma usually represents Non-Hodgkin's lymphoma. It may present with multiple, discrete mural masses with variability of size.
  • Carcinoid tumors
  • Kaposi's sarcoma

Other mural masses

  • Amyloidosis
  • Postinflammatory polyps are seen in the healing stages of inflammatory bowel disease.
  • Pneumatosis cystoides intestinalis is an idiopathic disorder characterized by gas collections in the intestinal wall, which can result in filling defects on contrast studies.

Intraluminal masses

  • Parasites (Ascaris, tapeworms)
  • Gallstones
  • Food, stool
  • Iatrogenic foreign bodies (tubes, catheters, ingested objects)
  • Blood clots
  • Inverted diverticula
*Gallstones and ingested foreign bodies often lodge at ileocecal juction

Lymphoid hyperplasia. Note the innumerous tiny filling defects.

Metastatic melanoma. Note the multiple large filling defects of varying size and shape.


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