Computed tomographic enteroclysis: one methodology.
OBJECTIVE
Computed tomography (CT) is limited in the assessment of partial small bowel obstruction (SBO). Enteroclysis is preferred but gives little direct information about the bowel wall, mesentery, or remote findings. Preliminary results of a combined CT enteroclysis (CT-E) methodology are reported.


METHODS
Forty-eight patients with suspected partial SBO underwent a water soluble contrast enteroclysis followed immediately by CT. Pump rates at fluoroscopy and CT were 75 to 100 cc/min unless a high-grade obstruction was encountered at fluoroscopy. Shrake's criteria for complete, high-grade or low-grade partial SBO were used.


RESULTS
The calculated dose per patient was 27 rad for CT-E as opposed to 32 rad with traditional enteroclysis. Site specific sensitivity and specificity for low-grade partial SBO, were 82.1% and 87.5%. One death was encountered in a patient with diffuse abdominal metastatic disease and complete obstruction. This was caused by vomiting and aspiration secondary to tube placement alone, CT-enteroclysis having been aborted.


CONCLUSIONS
Computed tomographic enteroclysis is a diagnostic option for evaluation of low-grade partial SBOs. Pitfalls with this technique are encountered in decompressed torsions and hernias.
Bender
G N
GN
Department of Radiology, Madigan Army Medical Center, Ft. Lewis, Tacoma, WA 98431-5000, USA.
Timmons
J H
JH
Williard
W C
WC
Carter
J
J
D000008:Abdominal Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D002423:Cause of Death; D003287:Contrast Media / Q000008:administration & dosage* / Q000737:chemistry; D005471:Fluoroscopy; D006547:Hernia / Q000000981:diagnostic imaging; D006801:Humans; D007410:Intestinal Diseases / Q000000981:diagnostic imaging; D007421:Intestine, Small / Q000000981:diagnostic imaging*; D007441:Intubation, Gastrointestinal / Q000009:adverse effects / Q000295:instrumentation*; D008643:Mesentery / Q000000981:diagnostic imaging; D011015:Pneumonia, Aspiration / Q000209:etiology; D011829:Radiation Dosage; D012680:Sensitivity and Specificity; D012995:Solubility; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014102:Torsion Abnormality / Q000000981:diagnostic imaging; D014839:Vomiting / Q000209:etiology; D014867:Water
D003287:Contrast Media; D014867:Water