İnce Barsak Hastalıklarında Enteroklizis’in Tanı Değeri

Abstract

Gereç-Yöntem:Üst ve alt gastrointestinal sistem değerlendirmesi ile nedeni açıklanamayan abdominal ağrılar, kronik diare, nedeni açıklanamayan ancak primer ince barsak hastalığı olasılığı taşıyan kilo kaybı, halsizlik, anemi gibi yakınma ve bulguları olan yaşları 15-84 (ort yaş 47.5) arasında değişen 9'u erkek, 7'si kadın toplam16 hastaya; baryum sülfat ve metil sellüloz eriyiğinin kullanıldığı Herlinger tekniği ile çift kontrast enteroklizis incelemesi yapıldı.Bulgular: Dört olguda malabsorbsiyon bulguları (ince barsak segmentlerinde dilatasyon, motilitede artış, mukozal sıvanmada azalma), Crohn hastalığı tanısı alan 3 olgudan ikisinde; terminal ileumde rijidite, distal kesimde ülserler, bir olguda kolon ½ distal kesiminde haustrasyon kaybı izlendi. Bir olguda askarise ait dolum defekti, 1 olguda çekum kitlesinin invazyonuna sekonder terminal ileumda rijidite ve mukozal düzensizlik, 1 olguda foldlarda kalınlaşma, 2 olguda ince barsak segmentlerine dıştan bası bulgusu, 2 olguda normal bulgular, 1 olguda motilitede azalma, 1 olguda terminal ileumda geçirilmiş operasyona sekonder değişiklikler izlendi. Material and Method:A total of 16 patients, 9 of which were male and 7 of which were female with an age range from 15 to 84 ( avarage 47.5) with abdominal pain which could not be explained by examining the upper and lower gastrointestinal system, chronic diarrhea, obcsure weight loss but suspected small intestine disease, asthenia, anemia, were investigated with double contrast enteroclysis examination using Herlinger method in which barium sulphate and methyl cellulose solution were used. Results:In four cases malabsorbion findings (dilation in small intestine segments, increase in motility, decrease in mucosal involvement); in 2 out of 3 cases with known Crohn disease rigidity in terminal ileum, ulcers in distal part; in one case loss of haustration in dismal half of the colon were detected. In one case filling defect by an ascaris; in one case rigidity in secondary terminal ileum to the invasion of cecum tumor and mucosal disorder; in one case thickening of folds; in two cases findings of external impression to small intestine segments; in two cases normal findings; in one case decrease in motility; in one case secondary changes to the operation in the terminal ileum were detected. Conclusion:Enteroclysis is an highly sensitive method of examination which has high accuracy rates at the diagnosis and differential diagnosis of small intestine diseases whose endoscopic and radiological examinations are limited.