Enteroclysis: The Small Bowel Enema
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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.
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, minimal 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.
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