The demise of the instant/unprepared contrast enema in large bowel obstruction

Abstract

MDCT was shown to be more accurate in the diagnosis of LBO, is usually available on a 24-h basis, and in many institutions has replaced the urgent CE in this group of patients. This also has the advantage of excluding incidental findings and in staging malignant disease.

Acute colonic pseudo‐obstruction in pregnancy

“…CT has replaced contrast enema as the modality of choice to exclude mechanical obstruction . Guidelines suggest that CT should be avoided during pregnancy unless the clinical indication outweighs the risks .…”

“…CT has replaced contrast enema as the modality of choice to exclude mechanical obstruction. 8 Guidelines suggest that CT should be avoided during pregnancy unless the clinical indication outweighs the risks. 9,10 Current evidence is that the risk of teratogenesis is not increased at radiation doses below 5-15 rad and abdominopelvic CT is estimated to deliver between 1 and 4 rad.…”

Síndrome dismórfico neonatal y síndrome de Ogilvie

“…El contraste predilecto es hidrosoluble, por el riesgo de extravasación y debido al efecto terapéutico que puede representar en este estudio al facilitar la descompresión del colon 3,22 ; sin embargo, la tomografía axial computada remplazó al colon por enema 3,23 , en un estudio retrospectivo de un periodo de 7 años que demostró que la tomografía tiene 96% de sensibilidad y 93% de especificidad para diagnosticar la oclusión del intestino grueso 3,21 y donde los hallazgos más comunes son: dilatación proximal con una zona de transición intermedia en la flexura esplénica o adyacente a ella, y no se observan imágenes oclusivas ni cambios de calibre súbitos, que indiquen oclusión mecánica 3,24 .…”

Acute Colonic Pseudoobstruction

“…A water soluble agent, such as gastrografin, should be used over barium in case a leak or perforation should occur. [11][12][13][14] A typical radiographic finding of ACPO on CT scan is proximal colonic dilation with a transition point at the level of the splenic flexure. [10][11][12][13][14]…”