Gastrointestinal Radiology > Procedures > Enteroclysis > Enteroclysis (7)


Enteroclysis: The Small Bowel Enema (cont.)

Contrast Materials

At least three different types of enteroclysis examination have been described:
  1. the single-contrast method with a barium suspension alone,

  2. the double-contrast method using an infusion of air, water, or methyl cellulose following the barium infusion,

  3. the biphasic method which combines the single- and the double-contrast procedures.

We use both single-contrast enteroclysis and biphasic enterolysis. The right barium mixture for each study will vary with the thickness of the patient's abdomen. The appropriate single-contrast barium suspension can be determined from the following table:

Barium Mixture for Single-Contrast Enteroclysis
Abdominal Thickness (cm in prone position) Barium (HD 85, Lafayette Phamacal) H2O (Cold Tap Water) w/v %   Specific
   Gravity
Child (11 or less) 1 (150 ml) 2-1/2 (375 ml) 24% 1.2
Thin adult (15-19) 1 (240 ml) 2 (480 ml) 28% 1.23
Normal adult (20-24) 1 (300 ml) 1-1/2 (450 ml) 34% 1.27
Obese adult (25+) 1 (360 ml) 1 (360 ml) 42% 1.32

(Modified from Miller RE, Sellink JL: Enteroclysis: The small bowel enema-how to succeed and how to fail. Gastrointest Radiol 1979;4:269)

 

A slightly less satisfactory but universal single-contrast barium suspension can be quickly prepared by filling a barium enema bag containing 12 ounces (340 grams) of Sol-O-Pake (E-Z Em Co.), with tap water up to the 1000 ml mark. This makes a 34% W/V barium solution.

  

 

The contrast agents for biphasic-contrast enteroclysis are as follows:
  1. Barium sulfate suspension: 400 mL of 50% w/v of EnteroBar (Lafayette Pharmaceuticals, Lafayette, IN). 
  2. Methylcellulose (Enterocel, Lafayette Pharmaceuticals, Lafayette, IN): 0.5% solution prepared by adding 1400 mL of water to 500 mL of Enterocel.