Value of the peroral pneumocolon in children

Da, Stringer; Sherman, Porter; Liu, P; Daneman, Alan

doi:10.2214/ajr.146.4.763

Cited by 11 publications

(2 citation statements)

References 6 publications

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“…Most of the published clinical series evaluating the use of the peroral pneumocolon surfaced in the 1980s [1,4,5,8,18]. In 1982, Kelvin and colleagues described the first formal assessment of the peroral pneumocolon technique specifically for evaluation of the terminal ileum [4].…”

Section: A Brief History Of the Fluoroscopic Peroral Pneumocolonmentioning

confidence: 99%

The peroral pneumocolon revisited: a valuable fluoroscopic and CT technique for ileocecal evaluation

Pickhardt

2011

Abdom Imaging

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The peroral pneumocolon represents a time-honored but somewhat forgotten and underutilized technique for improved ileocecal evaluation at small bowel fluoroscopy. The peroral pneumocolon entails fluoroscopically guided gaseous insufflation per rectum following the arrival of barium at the cecum at conventional small bowel follow-through examination. In most cases, high-quality double contrast evaluation of the terminal ileum can be achieved, often superior to enteroclysis examination for this critical location. The peroral pneumocolon improves diagnostic confidence, including assessment of disease activity, and may result in a reversal of the diagnostic impression. This simple procedure will be discussed and a spectrum of fluoroscopic findings with CT and endoscopic correlation will be provided to demonstrate the added yield of this technique in the evaluation of known or suspected Crohn's disease. Application of the pneumocolon technique to CT for combined small and large bowel evaluation ("CT coloenterography") will also be discussed, which represents an attractive new option for investigating inflammatory bowel disease and other bowel-related conditions. Through the use of automated low-pressure carbon dioxide delivery per rectum, supplemented by IV glucagon for relaxation of the ileocecal valve, a CT-based pneumocolon examination may prove to be a useful hybrid technique for bowel evaluation in the future.

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Section: A Brief History Of the Fluoroscopic Peroral Pneumocolonmentioning

confidence: 99%

The peroral pneumocolon revisited: a valuable fluoroscopic and CT technique for ileocecal evaluation

Pickhardt

2011

Abdom Imaging

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“…Small bowel evaluation by barium meal follow through (BMFT) and colonic evaluation by double contrast barium enema (DCBE) are the standard norms [1] . The technique of pneumocolon has been used previously to evaluate the terminal ileum and caecum [2][3][4][5] . Performing pneumocolon along with BMFT at the same time evaluates both the small as well as the large bowel and is more economical than the combination of BMFT and barium enema.…”

Section: Introductionmentioning

confidence: 99%

Barium meal follow through with pneumocolon: Screening test for chronic bowel pain

Nijhawan¹,

Kumpawat²,

Mallikarjun³

et al. 2008

WJG

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AIM:To study the sensitivity, specificity and cost effectiveness of barium meal follow through with pneumocolon (BMFTP) used as a screening modality for patients with chronic abdominal pain of luminal origin in developing countries. M E T H O D S : F i f t y p a t i e n t s a t t e n d i n g t h eGastroenterology Unit, SMS Hospital, whose clinical evaluation revealed chronic abdominal pain of bowel origin were included in the study. After routine testing, BMFT, BMFTP, contrast enhanced computed tomography (CECT) of the abdomen, barium enema and colonoscopy were performed. The sensitivity, specificity and cost effectiveness of these imaging modalities in the detection of small and/or large bowel lesions were compared. RESULTS: Out of fifty patients, structural pathology was found in ten. Nine out of these ten patients had small bowel involvement while seven had colonic involvement alone or in combination with small bowel involvement. The sensitivity of BMFTP was 100% compared to 88.89% with BMFT when detecting small bowel involvement (BMFTP detected one additional patient with ileocecal involvement). The sensitivity and specificity of BMFTP for the detection of colonic pathology were 85.71% and 95.35% (41/43), respectively. Screening a patient with chronic abdominal pain (bowel origin) using a combination of BMFT and barium enema cost significantly more than BMFTP while their sensitivity was almost comparable. CONCLUSION: BMF TP should be included in the investigative workup of patients with chronic abdominal pain of luminal origin, where either multiple sites (small and large intestine) of involvement are suspected or the site is unclear on clinical grounds. BMFTP is an economical, quick and comfortable procedure which obviates the need for colonoscopy in the majority of patients.

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