Of 519 consecutive patients examined by enteroclysis, 12 (2.3%) were found to have acquired diverticula of the jejunum and ileum. All except one patient had multiple diverticula, most occurring in the jejunum. In only one patient could symptoms be ascribed to the abnormality. The combination of intraluminal distention and extrinsic abdominal compression provided by the enteroclysis technique appears to be the most reliable method for the demonstration of small-bowel diverticula. A discussion of the complications that may result from acquired jejunoileal diverticulosis and a review of the literature are presented.
Of 71 patients diagnosed with primary mesenteric malignant tumors in the small bowel over a 21-year period in a community/teaching hospital, 14 underwent small-bowel follow-through, 16 underwent small-bowel enema (enteroclysis), and four patients underwent both studies preoperatively. In a retrospective study, the sensitivity of both the small-bowel enema and the conventional small-bowel follow-through examination were compared on the basis of the original radiologic interpretation. The studies were ordered by clinicians in a clinical setting. Results of the small-bowel follow-through were abnormal in 11 of 18 patients for a sensitivity of 61%, and small-bowel enema showed abnormalities in 19 of 20 patients for a sensitivity of 95% (p = .0165). The actual tumor was shown in six (33%) of 18 small-bowel follow-through studies and in 18 (90%) of 20 small-bowel enemas (p = .0005). In four patients, normal findings on conventional small-bowel follow-through were followed by abnormal findings on small-bowel enema done for the same reason. This experience suggests that the small-bowel enema is more sensitive than the conventional follow-through examination for the detection of small-bowel cancers.
Since the advent of endoscopy for evaluating the upper and lower gastrointestinal (GI) tracts, it has become clear that only in the small bowel does barium radiography remain unchallenged. Regrettably, barium examination of the small bowel has traditionally been regarded by many radiologists as a study of minor importance. Small bowel follow-through techniques and enteroclysis methods differ in their diagnostic purpose, potential, and methods of performance. This review examines in detail the spectrum of barium examination techniques currently available for evaluating the small bowel. The benefits of enteroclysis in the majority of clinical situations requiring contrast examination of the small bowel are stressed. Radiologists play the crucial role in the diagnostic evaluation of the small bowel and should strive to refine and advance the accuracy of small bowel radiography.
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