Crohn disease of the small intestine: accuracy and relevance of enteroclysis.

Abstract

The accuracy and clinical relevance of enteroclysis in the evaluation of 138 patients referred for enteroclysis for suspected Crohn disease of the small intestine are reported. The original prospective interpretations of enteroclysis results were assessed after a clinical follow-up period of 2 or more years. With all patients considered, enteroclysis had a sensitivity, specificity, and accuracy of 100%, 98.3%, and 99.3%, respectively, with only one false-positive diagnosis and no false-negative diagnoses. Thirty-one percent (n = 43) of the patients had lesions of early Crohn disease. All patients who required surgery (n = 23) had advanced lesions of the disease, according to enteroclysis criteria. Clinical evidence of Crohn disease did not develop in the 58 patients in whom enteroclysis revealed no abnormality. There were no complications related to the procedure. It is concluded that enteroclysis is an accurate method for diagnosis and exclusion of Crohn disease of the small intestine and provides detailed structural information relevant to appropriate management of the disease.

CT enteroclysis: technique and clinical applications

“…The sensitivity of conventional double-contrast barium enteroclysis for Crohn's disease ranges between 98.2-100%, as was demonstrated on 168 [8] and 143 patients [13], respectively, whereby Maglinte et al had included 43 patients [31%] with early lesions. The diagnostic accuracy of cross-sectional imaging modalities, including CTE, remains controversial for the initial stage of Crohn's disease [36,40,46,47].…”

“…The diagnostic accuracy of cross-sectional imaging modalities, including CTE, remains controversial for the initial stage of Crohn's disease [36,40,46,47]. Their spatial resolution is still inferior to that of conventional double contrast enteroclysis [13] and does not allow detailed analysis of the small bowel mucosa. Therefore, early mucosal inflammation, histopathologically characterized as aphtoid ulcerations and enlarged lymphoid follicles, is not constantly visualized by CTE, even with the given improvements of multidetector row technology [26,36].…”

İnce Barsak Hastalıklarında Enteroklizis’in Tanı Değeri

“…Yaygın ülserasyonun neden olduğu irritabiliteye bağlı spazm ve ödem ile oluşan "string sign", konvansiyonel pasaj grafilerinde gerçek striktür-den ayırd edilemez. Ancak enteroklizisde metil sellüloz infüzyonu ile sağla-nan barsak lümeninin distansiyonu sayesinde spazm veya ödeme bağlı darlık ile striktür kolaylıkla ayırd edilebilmektedir (7,11). Bu ayırım da klinisyene medikal veya cerrahi tedavi tercihinde yardımcı olmaktadır.…”

Diagnosing Crohn's Disease: An Economic Analysis Comparing Wireless Capsule Endoscopy with Traditional Diagnostic Procedures

“…41,43 Although enteroclysis may be more sensitive than SBFT, it has been reported to require a longer procedure time, involves more radiation exposure than routine small bowel series, 44 and is more invasive since the physician must insert a tube into the patient's small intestine through the nose or mouth. 21,34,45,46 Enteroclysis is commonly used in Europe. However, in the United States enteroclysis is not routinely available at many centers and is thus not widely used in the evaluation of Crohn's disease.…”