The value of the small bowel enema to the general surgeon

Abstract

Lesions of the small bowel are notoriously difficult to diagnose, many only coming to light at laparotomy. At this hospital the small bowel enema has been used for radiology of the small bowel for many years. The procedure is uncomfortable for the patient, as intubation of the proximal small bowel is essential, and for the radiologist it can be very time-consuming. A review of patients referred by the general surgeons over the past 5 years has demonstrated the value of the technique. It has proved to be accurate in over 90 per cent of cases with only 2 per cent false negative and 1 per cent false positive results. The most common diagnosis has been Crohn's disease which can be very accurately assessed. Other lesions diagnosed include lymphoma, involvement by metastases, benign stricture and adhesions. A normal results has prevented an unnecessary laparotomy in several patients. It is concluded that this technique is the most satisfactory method for radiology of the small bowel and it should be much more widely available.

Enteric ulceration and its complications

“…from nowhere, bleeding from the small bowel." The most valuable investigation in our experience bas been the small bowel enema as illustrated by cases 1 and 2 [8][9][10][11]. No one test is ideal, however.…”

“…The diagnostic rate can be improved where necessary by the simultaneous infusion of methylcellulose, water, or air down the tube [7]. This method of examination has yielded over 90% positive diagnoses in certain series [8,11]. Although some workers find it time-consuming and uncomfortable for the patient [11], others stress that it is easy to perform, safe, and quick [7].…”

“…This method of examination has yielded over 90% positive diagnoses in certain series [8,11]. Although some workers find it time-consuming and uncomfortable for the patient [11], others stress that it is easy to perform, safe, and quick [7]. Itis frequently successful in situations in which a follow-through has failed to reveal any pathological features [10].…”

“…Superior mesenteric arteriogram showing a "tumor blush" or "vascular malformation" in the ileum. barium follow-through being reserved for patients in whom duodenal intubation cannot be achieved [11].…”