Air (CO2) double-contrast barium enteroclysis.
In the 1980s and 1990s in North America and Europe, air (CO(2)) double-contrast barium enteroclysis took a back seat to biphasic methylcellulose double-contrast enteroclysis in the investigation of small-bowel diseases. The widespread application of capsule endoscopy in the 21st century has identified a number of limitations of radiologic examinations in the investigation of mucosal diseases of the small intestine. Evidence-based studies comparing barium, computed tomographic (CT), and magnetic resonance (MR) enteroclysis have shown that in spite of improvements in small-bowel examination methods using CT and MR, barium examinations remain superior in the depiction of mucosal abnormalities, particularly the apthoid lesions of early Crohn disease. Barium small-bowel examinations have been recommended in the patient with a negative CT or MR enteroclysis study where the pretest probability of Crohn disease is high. A recent prospective comparison of methylcellulose double-contrast barium enteroclysis to capsule endoscopy with review of the literature has shown that air enteroclysis depicts mucosal details better than does methylcellulose double-contrast enteroclysis because of the "washout" effect of methylcellulose on superficial mucosal features. Recent articles have shown that air enteroclysis compares favorably with wireless capsule endoscopy and double-balloon endoscopy in the diagnosis of mucosal abnormalities of the small bowel. This article describes the authors' technique of performing air double-contrast enteroclysis, its clinical indications, and its pitfalls.
Maglinte
Dean D T
DD
Department of Radiology, Indiana University School of Medicine, Indiana University Hospital, 550 N University Blvd, UH0279, Indianapolis, IN 46202-5253, USA. dmaglint@iupui.edu
Kohli
Marc D
MD
Romano
Stefania
S
Lappas
John C
JC
D001466:Barium Sulfate; D053704:Capsule Endoscopy / Q000379:methods; D002245:Carbon Dioxide; D003287:Contrast Media; D003424:Crohn Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007421:Intestine, Small / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008747:Methylcellulose; D014057:Tomography, X-Ray Computed / Q000379:methods
D003287:Contrast Media; D002245:Carbon Dioxide; D001466:Barium Sulfate; D008747:Methylcellulose