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Current status of small bowel radiography
D D Maglinte1, F M Kelvin, K O'Connor
1Department of Radiology, Methodist Hospital of Indiana and Indiana University School of Medicine, 1701 North Senate Boulevard, Indianapolis, IN 46206, USA.
Abdominal Imaging
|May 1, 1996
Summary
Small bowel radiography is crucial for diagnosing conditions like GI bleeding and Crohn disease. Enteroclysis is recommended as the primary imaging method for better patient evaluation and management.
Area of Science:
- Radiology
- Gastroenterology
- Medical Imaging
Background:
- Small bowel examinations were historically performed without specific indications.
- This review focuses on clinical issues and the role of small bowel radiography in diagnosing small bowel disease.
Purpose of the Study:
- To examine the clinical utility of small bowel radiography.
- To provide recommendations for its use in evaluating patients with suspected small bowel disease.
Main Methods:
- A comprehensive literature search was conducted using Medline and Current Contents from 1980 to July 1995.
- Analysis of citations focused on indications and techniques for small bowel radiography.
Main Results:
- Key indications include unexplained GI bleeding, suspected tumors, obstruction, Crohn disease, and malabsorption.
- Enteroclysis is highlighted as a valuable diagnostic tool, though a debate exists regarding its primary use over conventional methods.
- Limitations of conventional small bowel follow-through are discussed, along with modifications to improve diagnostic yield.
Conclusions:
- Thoughtful patient selection is essential for cost-effective radiologic evaluation of the small intestine.
- Enteroclysis is recommended as the primary method due to its high diagnostic yield and negative predictive value.
- Conventional small bowel follow-through should be abandoned, with fluoroscopy-based methods as acceptable alternatives when enteroclysis is not feasible.