Feasibility of the peroral pneumocolon in evaluating the ileocecal region

Retrograde insufflation of air into the terminal ileum via a rectal tube (peroral pneumocolon) is a simple adjunct to the conventional gastrointestinal small-bowel follow-through examination. The purpose of this study was to determine the feasibility and diagnostic value of peroral pneumocolon in 170 patients who were being evaluated by upper gastrointestinal series with conventional small-bowel follow-through. Retrograde passage of air into the terminal ileum was successful in 87% of 140 patients with normal anatomic relations and in all 30 patients with small bowel-colonic anastomoses. In most cases, retrograde air insufflation yielded additional diagnostic information, particularly in detection of ulcerations, edematous mucosa, and cobblestone patterns. The length of the small bowel segment affected by pathologic changes could be determined more accurately in over 60% of the peroral pneumocolon examinations. No procedure-related complications were observed.