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- ArticleOlmsted WW, Reagin DE.AJR Am J Roentgenol. 1976 Sep;127(3):423-8.Enlargement of the valvulae conniventes is an integral part of the pattern diagnosis of primary small bowel disease causing malabsorption. The pathophysiology underlying enlargement of the fold and the most typical diseases with prominent folds leading to malabsorption are discussed. Differential diagnosis is based on enlargement of the fold and on secondary signs.