Introduction

There is evidence to indicate that examination of the small intestine by enteroclysis represents an improvement over the small bowel follow-through as it is performed by many, if not most radiologists, as an afterthought or continuation of the upper GI series.

Specific advantages reported for enteroclysis include the following:

The regulating action of the stomach and pylorus are bypassed, and contrast can be administered at a controlled rate.
The fluid overload produced by the barium infusion temporarily decreases small bowel motor activity. This hypotonia makes demonstration of lesions easier because abnormalities are more clearly visible when the intestine is distended rather than contracted. As a result of the dilatation, mild strictures, small sinus tracts and fistulas, and minimal extrinsic compressions can be visualized.
Simultaneous demonstration of the entire small bowel in a state of distention allows better delineation of skip lesions and the proximal and distal extent of diffuse diseases.
Once the tube is in place, the examination can be completed in 15-30 minutes, thus reducing patient waiting time.

The disadvantages of enteroclysis are as follows:

A thorough colon preparation is necessary, which is uncomfortable for the patient and requires 18-24 hours.
Transnasal or transoral intestinal intubation produces patient discomfort.
The presence of a radiologist is necessary during all phases of the examination. A radiologist and a R/F room are tied up longer.
The patient receives approximately 5 times more radiation than with a SBFT.