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Masses projecting into or occurring with the small
intestine appear as filling defects on fluoroscopic studies.
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These filling defects may represent intraluminal,
mucosal, intramural, or extrinsic masses.
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It can be difficult to distinguish the origin of a
mass based on its fluoroscopic appearance, and CT is often a necessary
adjunct to more clearly delineate the extent of the lesion.
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Some clues can be obtained, however, from
fluoroscopy that can aid in determining the location of the mass. The most important aspect is the
angle that the margins of the mass make with the intestinal wall. Extrinsic or intramural masses will
form obtuse margin angles, while mucosal masses will form acute angles. Pedunculated masses will appear
(surprisingly) pedunculated, and intraluminal masses will be filling defects
completely surrounded by barium.
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“Bull’s-eye” or “target” lesions are filling
defects that contain a central area of barium collection. This appearance denotes ulceration
and is often (but not always) associated with malignancy.
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Intramural
Mucosal
Intraluminal
Target lesion
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