Duodenal Intubation

• For enteroclysis, infusion of contrast fluid is done through a tube inserted into the distal duodenum or proximal jejunum.
• The tip of the tube must be inserted at least as far as the 4th portion of the duodenum to avoid reflux into the stomach. Gastric reflux will cause nausea, vomiting, and loss of prograde peristalsis, thus retarding or halting the examination.
• The catheter used for intubation is a modification of the Bilbao-Dotter tube. The tube is stiffened and directed with a curved-tip, teflon-coated torque cable. We use one of two modifications which are narrower and longer than the original Bilbao-Dotter tube: either the 12 French, 135 cm. Herlinger modification (Cook Inc., Bloomington, IN) or the 13 Fr., 155 cm. Maglinte modification (Lafayette Pharmacal Inc., Lafayette, IN). The latter tube has a 15 ml capacity balloon proximal to the side holes which can be inflated to prevent reflux of contrast fluid into the stomach.