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Computed tomographic enteroclysis: one methodology

G N Bender1, J H Timmons, W C Williard

  • 1Department of Radiology, Madigan Army Medical Center, Ft. Lewis, Tacoma, WA 98431-5000, USA.

Investigative Radiology
|January 1, 1996
PubMed
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Computed tomographic enteroclysis (CT-E) offers a diagnostic option for evaluating low-grade partial small bowel obstruction (SBO). This combined technique provides better insights than traditional methods, with acceptable radiation exposure.

Area of Science:

  • Radiology
  • Gastroenterology
  • Abdominal Imaging

Background:

  • Computed tomography (CT) has limitations in assessing partial small bowel obstruction (SBO).
  • Enteroclysis is preferred for SBO but offers limited information on bowel wall, mesentery, or remote findings.
  • A combined CT enteroclysis (CT-E) methodology aims to improve diagnostic capabilities.

Purpose of the Study:

  • To report preliminary results of a combined CT enteroclysis (CT-E) methodology.
  • To evaluate CT-E as a diagnostic option for partial SBO.
  • To compare radiation dose and diagnostic accuracy with traditional enteroclysis.

Main Methods:

  • Forty-eight patients with suspected partial SBO underwent water-soluble contrast enteroclysis followed immediately by CT.

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  • Standardized pump rates were used, adjusted for high-grade obstructions.
  • Shrake's criteria were applied for classifying SBO severity.
  • Main Results:

    • The calculated radiation dose for CT-E was 27 rad per patient, lower than traditional enteroclysis (32 rad).
    • Site-specific sensitivity and specificity for low-grade partial SBO were 82.1% and 87.5%, respectively.
    • One death occurred due to complications of tube placement in a patient with complete obstruction and metastatic disease.

    Conclusions:

    • Computed tomographic enteroclysis is a viable diagnostic option for evaluating low-grade partial SBO.
    • Potential pitfalls include challenges in assessing decompressed torsions and hernias.
    • CT-E enhances visualization of bowel wall and mesentery compared to conventional enteroclysis.