Enteroclysis in the diagnosis of chronic unexplained gastrointestinal bleeding

Maglinte, Dean D. T.; Elmore, Michael F.; Chernish, Stanley M.; Miller, Roscoe E.; Lehman, Glen A.; Bishop, Robert; Blitz, Gregory; Kohne, John; Isenberg, Michael T.

doi:10.1007/bf02560223

Cited by 27 publications

(7 citation statements)

References 14 publications

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“…These lesions, as well as some other structural lesions of the small intestine including mass lesions, ulcers, and Crohn's disease, may be detected by barium contrast studies of the small intestine. The literature suggests that small bowel enema techniques (enteroclysis) may have an increased diagnostic yield over standard small bowel follow-through series (45,46).…”

Section: Ajg -August 1998mentioning

confidence: 99%

Management of the Adult Patient With Acute Lower Gastrointestinal Bleeding

Zuccaro¹

1998

American Journal of Gastroenterology

209

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Section: Ajg -August 1998mentioning

confidence: 99%

Management of the Adult Patient With Acute Lower Gastrointestinal Bleeding

Zuccaro¹

1998

American Journal of Gastroenterology

209

View full text Add to dashboard Cite

“…Several studies in the literature have reported a greater diagnostic yield for enteroclysis than for small bowel follow-through. (7)(8)(9)(10)(11)(12). For gastrointestinal bleeding the diagnostic yields range from 10 to 25% (13)(14)(15).…”

mentioning

confidence: 99%

A Retrospective Review of Enteroclysis in Patients with Obscure Gastrointestinal Bleeding and Chronic Abdominal Pain of Undetermined Etiology

et al. 2005

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Our purpose was to determine the diagnostic utility of enteroclysis in the evaluation of obscure gastrointestinal bleeding and abdominal pain of unknown etiology. This is a retrospective review of 97 consecutive patients (mean age, 54.1+/-17.5 [SD] years; 49 male and 48 female) who underwent enteroclysis at Temple University Hospital from January 1994 to October 2001 for the evaluation of obscure GI bleeding or chronic abdominal pain of undetermined etiology. Prior to enteroclysis all patients had an EGD and colonoscopy, which were nondiagnostic for their symptoms. Sixty-three patients (64.9%) had enteroscopy performed prior to enteroclysis that was also negative. Enteroclysis results were defined as positive based on anatomical or functional abnormalities. Analysis of the data included the percentage yield of positive exams, the percentage of positive results per symptom category, and the percentage of patients with a change in clinical management based on positive enteroclysis results. Ninety-seven patients underwent enteroclysis. The indications for enteroclysis were obscure GI bleeding in 67 patients (69.1%) and chronic abdominal pain in 30 patients (30.9%). The number of positive exams was 19 (19.6%). Fourteen of the 67 patients with the indication of GI bleeding had a positive exam (21%), while 5 of the 30 patients with chronic abdominal pain had a positive result (16.7%). There was a change in clinical management due to the enteroclysis results in 10 patients: 7 patients with GI bleeding (10%) and 3 patients with chronic abdominal pain (10%). Positive enteroclysis findings included adhesions (7), filling defects and masses (5), strictures (2), small bowel diverticulosis (1), mucosal abnormalities (3), and a motility disorder (1). The overall positive yield for enteroclysis was 19.6%, with a yield of 16.7% for chronic abdominal pain and 21% for gastrointestinal bleeding. Enteroclysis results changed the clinical management in approximately 10% of the patients.

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“…SBE studies have been advocated for the detection of a variety of small-bowel diseases, including small-bowel obstruction, gastrointestinal bleeding, and Crohn's disease [5][6][7][8][9]. In a recent study by Maglinte et al [10], SBE studies were found to be accurate in excluding Crohn's disease when a carefully performed SBE was normal.…”

Section: Discussionmentioning

confidence: 98%

Does a normal small-bowel enteroclysis exclude small-bowel disease? a long-term follow-up of consecutive normal studies

Barloon

Honda

et al. 1994

Abdom Imaging

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The purpose of our study was to determine if a normal small-bowel enteroclysis excludes small-bowel disease in adult patients, using long-term follow-up as the major reference standard. We reviewed 193 consecutive small-bowel enteroclysis (SBE) studies completed during a period from January 1987 to February 1989, of which 83 were judged to be normal at the time of the study. Eight of these latter patients were excluded due to inadequate follow-up. The indications included detection of gastrointestinal bleeding, small-bowel obstruction, Crohn's disease, nonspecific abdominal pain, chronic diarrhea, and a miscellaneous group. Each patient was followed for at least 3 years by chart review or until a definite diagnosis was established. Six of the 75 patients whose SBE was originally interpreted as normal were eventually judged to have small-bowel disease. The remaining 69 patients were judged to be free of small-bowel disease by autopsy, surgical laparotomy, endoscopic observation or biopsy, or long-term follow-up for at least 3 years. Therefore, a normal SBE correctly excluded small-bowel disease in 69 of our 75 patients (true negatives) and failed to diagnose disease in six patients (false negatives), for a specificity of .92 +/- .03 (SE). In this experience, SBE was sufficiently specific in most patients to exclude small-bowel disease.

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Enteroclysis in the diagnosis of chronic unexplained gastrointestinal bleeding

Cited by 27 publications

References 14 publications

Management of the Adult Patient With Acute Lower Gastrointestinal Bleeding

Management of the Adult Patient With Acute Lower Gastrointestinal Bleeding

A Retrospective Review of Enteroclysis in Patients with Obscure Gastrointestinal Bleeding and Chronic Abdominal Pain of Undetermined Etiology

Does a normal small-bowel enteroclysis exclude small-bowel disease? a long-term follow-up of consecutive normal studies

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