Abstract
Normal small intestinal folds are less than 2mm in thickness and criss-cross in appearance. Many diseases
of the small interstine produce an abnormality in mucosal folds, namely thickening and parallel (perpendiulcer
to the bowel lumen) arrangement of folds, nodularity, destruction, and ulcer. Diseases causing submucosal
edema produce regular smooth thickening whereas diseases producing submucosal hemorrhage produce
regular spiky thickening. Inflammatory bowel diseases and lymphoma produce irregular (in width, or distorted or
'bent at peculiar angles to the bowel lumen) thickening nodularity of the mucosa. Severe inflammatory
processes as well as malignant tumors produce mucosal destruction and ulcer. Proposed here is an approach
to narrow the category of disease processes based on mucosal fold abnormality. This approach with sufficient
clinical history is invaluable in the interpretation of small bowel series.