Contrast enema before bypass surgery for small-bowel obstruction in the oncologic patient: is it necessary?
OBJECTIVE
We performed a retrospective study to determine the usefulness of contrast enema examinations in patients with small-bowel obstruction and known intraabdominal malignancy.


METHODS
Thirty-two patients with known or suspected intraabdominal malignancy and small-bowel obstruction who underwent both CT and subsequent contrast enema were identified. CT and contrast enema reports were reviewed for patients with tumor involvement of the colon to determine whether the contrast enema findings had provided additional information to the data that had been acquired with CT. In cases in which the contrast enema had provided additional information, the patients' medical records were reviewed to determine whether treatment had been modified as a result of the additional information.


RESULTS
In 14 (44%) of 32 patients, the contrast enema provided evidence of synchronous colonic disease not previously detected. The colonic involvement could be classified into two categories: implants (n = 1) and narrowing or complete obstruction (n = 13). Findings of the contrast enema resulted in a change in treatment in 10 (32%) of 32 of our patient population.


CONCLUSIONS
Patients with known intraabdominal malignancy who present with small-bowel obstruction may have synchronous large-bowel disease that is undetectable on standard CT scans. In these patients, the additional information provided by the contrast enema altered subsequent treatment.
Department of Radiology, New York-Presbyterian Hospital, 525 E 68th St., New York, NY 10021, USA.
Keith D
KD
Hentel
Marc J
MJ
Gollub
D000008:Abdominal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate; D003287:Contrast Media; D004733:Enema; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging* / Q000473:pathology; D007421:Intestine, Small / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D001466:Barium Sulfate