Fluoroscopic and CT enteroclysis in children: initial experience, technical feasibility, and utility

Area of Science:

• Pediatric Radiology
• Gastrointestinal Imaging

Background:

• Partial small-bowel obstruction is challenging to diagnose clinically and may be missed on routine CT scans.
• Accurate imaging is crucial for timely diagnosis and management of pediatric gastrointestinal conditions.

Purpose of the Study:

• To assess the feasibility, safety, and techniques of fluoroscopic enteroclysis (FE) and CT enteroclysis (CTE) in children.
• To review the indications and diagnostic findings of FE and CTE in pediatric patients.

Main Methods:

• Retrospective review of 112 FE and 74 CTE studies in children under 18 (2002-2007).
• Correlation of enteroclysis results with other imaging, surgical, and pathological findings.
• Analysis of patient demographics, indications, and outcomes.

Main Results:

• FE and CTE were most commonly used for Crohn disease and abdominal pain evaluation.
• No complications were reported; studies were well-tolerated.
• Common diagnoses included Crohn disease (34% FE, 28% CTE) and partial small bowel obstruction (3% FE, 10% CTE).
• CTE identified more extrinsically located abnormalities (19%) compared to FE (2%).
• Additional bowel abnormalities were noted in 11 FE and 25 CTE studies for inflammatory bowel disease patients.

Conclusions:

• Fluoroscopic enteroclysis and CT enteroclysis are safe, feasible, and accurate for diagnosing pediatric small bowel pathology.
• These imaging modalities are particularly valuable for children with small bowel Crohn disease.
• FE and CTE provide crucial diagnostic information for pediatric gastrointestinal conditions.