Computed tomographic enterography and enteroclysis: pearls and pitfalls

Area of Science:

• Gastroenterology
• Radiology
• Medical Imaging

Background:

• Traditional CT and fluoroscopic studies have limitations in visualizing the small bowel mucosa and wall.
• Enteric hyperhydration with negative contrast agents enhances small bowel distension for improved imaging.
• CT enterography and enteroclysis represent advancements in small bowel imaging.

Purpose of the Study:

• To compare the efficacy of CT enterography and enteroclysis with traditional imaging methods.
• To highlight the advantages of CT enterography in assessing small bowel pathologies.
• To establish CT enterography as a first-line modality for suspected Crohn's disease.

Main Methods:

• CT enterography involves oral hyperhydration.
• CT enteroclysis requires nasoenteric tube placement for fluid administration.
• Both methods utilize negative contrast agents for small bowel distension.

Main Results:

• CT enterography and enteroclysis provide superior visualization of the small bowel mucosa and wall.
• CT enterography is less invasive than CT enteroclysis when tolerated.
• CT enterography excels at identifying extraenteric findings like fistulas and abscesses.

Conclusions:

• CT enterography is the preferred, non-invasive imaging modality for small bowel assessment.
• It is the most appropriate imaging modality for suspected Crohn's disease.
• CT enterography is increasingly utilized for infections, neoplasms, and adhesions of the small bowel.