title: Enteroclysis: Current clinical value.
abstract: OBJECTIVE
  To retrospectively analyze changes in clinical indication, referring medical specialty and detected pathology for small bowel double-contrast examinations.
  
  
  METHODS
  Two hundred and forty-one (n = 143 females; n = 98 males; 01.01.1990-31.12.1990) and 384 (n = 225 females; n = 159 males; 01.01.2004-31.12.2010) patients underwent enteroclysis, respectively. All examinations were performed in standardized double-contrast technique. After placement of a nasojejunal probe distal to the ligament of Treitz, radiopaque contrast media followed by X-ray negative distending contrast media were administered. Following this standardized projections in all four abdominal quadrants were acquired. Depending on the detected pathology further documentation was carried out by focused imaging. Examination protocols were reviewed and compared concerning requesting unit, indication and final report.
  
  
  RESULTS
  Two hundred and forty-one examinations in 1990 faced an average of 55 examinations per year from 2004-2010. There was an increase of examinations for gastroenterological (33.6% to 64.6%) and pediatric (0.4% to 7.8%) indications while internal (29.0% to 6.0% for inpatients and from 16.6% to 9.1% for outpatients) and surgical (12.4% to 7.3%) referrals significantly decreased. "Follow-up of Crohn's disease" (33.1%) and "bleeding/tumor search" (15.1%) represented the most frequent clinical indications. A total of 34% (1990) and 53.4% (2004-2010) examinations yielded pathologic findings. In the period 01.01.2004 -31.12.2010 the largest proportion of pathological findings was found in patients with diagnosed Crohn's disease (73.5%), followed by patients with abdominal pain (67.6% with history of surgery and 52.6% without history of surgery), chronic diarrhea (41.7%), suspected Crohn's disease (39.5%) and search for gastrointestinal bleeding source/tumor (19.1%). The most common pathologies diagnosed by enteroclysis were "changes in Crohn's disease" (25.0%) and "adhesions /strictures" (12.2%).
  
  
  CONCLUSIONS
  "Crohn's disease" represents the main indication for enteroclysis. The relative increase of pathologic findings reflects today's well directed use of enteroclysis.
authors.affiliation: Adel Maataoui, Thomas J Vogl, Volkmar Jacobi, M Fawad Khan, Institute for Diagnostic and Interventional Radiology, Goethe University, 60590 Frankfurt am Main, Germany.
authors.forename: Adel
authors.initials: A
authors.lastname: Maataoui
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Vogl
authors.forename: Volkmar
authors.initials: V
authors.lastname: Jacobi
authors.forename: M Fawad
authors.initials: MF
authors.lastname: Khan
keywords: Double-Balloon enteroscopy; Fluoroscopy; Helical computed tomography; Inflammatory bowel diseases; Magnetic resonance imaging
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