The value of the small bowel enema to the general surgeon

Lesions of the small bowel are notoriously difficult to diagnose, many only coming to light at laparotomy. At this hospital the small bowel enema has been used for radiology of the small bowel for many years. The procedure is uncomfortable for the patient, as intubation of the proximal small bowel is essential, and for the radiologist it can be very time-consuming. A review of patients referred by the general surgeons over the past 5 years has demonstrated the value of the technique. It has proved to be accurate in over 90 per cent of cases with only 2 per cent false negative and 1 per cent false positive results. The most common diagnosis has been Crohn's disease which can be very accurately assessed. Other lesions diagnosed include lymphoma, involvement by metastases, benign stricture and adhesions. A normal results has prevented an unnecessary laparotomy in several patients. It is concluded that this technique is the most satisfactory method for radiology of the small bowel and it should be much more widely available.