No abstract

Retrospective analysis of 1,020 conventional antegrade small-bowel examinations revealed that the variable which correlated most highly with abnormal radiographic findings was the clinical complex of history, physical examination, and laboratory data which prompted suspicion of small-bowel disease. Thirty indications of possible small-bowel disease were divided into groups carrying (a) a high suspicion and (b) a low suspicion of disease. Pertinent abnormalities were revealed by 14.2% of examinations in the high-suspicion group, compared with 4.9% in the low-suspicion group. The individual indications covered a spectrum of 0-34% abnormality. Overall, 9.7% of examinations (99/1,020) revealed abnormalities, but only 6.6% (67/1,020) were pertinent to the clinical problems. The authors conclude that the efficacy of the small-bowel series is directly dependent upon the reason(s) for which it is performed.

No abstract

Forty-two surgically confirmed small-bowel lesions that were not detected by small-bowel follow-through but were demonstrated by enteroclysis were analyzed to determine why small-bowel follow-through had failed to detect them. Thirty lesions (71%) were not seen in retrospect; this was attributed to technical inadequacies. Twelve lesions (29%) were seen in retrospect. Of these, two (17%) of the lesions had been missed originally because of perceptive errors, seven (58%) because of combined perceptive and technical errors, and three (25%) because of interpretive errors. The preponderance of technical errors emphasizes the need for improvements in the small-bowel follow-through technique. More frequent fluoroscopy and more thorough compression of all filled segments, as is performed in enteroclysis, and a decreased reliance on overhead radiographs should decrease the error rate in the routine small-bowel follow-through examination.

No abstract