Enteroclysis
Encyclopedia
Enteroclysis is a fluoroscopic X-ray
of the small intestine
. Radiocontrast
is infused through a tube inserted through the nose to the duodenum
, and images are taken in real time as the contrast moves through aided by administration of methyl cellulose. Enteroclysis is also known by the confusing misnomer "Small bowel enema". 'Enema' is confusing as it suggests that the contrast material is introduced through the anal route.
It is the gold standard for evaluating small bowel diseases like Crohn's, though it has largely been replaced by CT enterography. CT enteroclysis is now available which combines the advantages of CT (ample extraluminal information and visualization) and conventional enteroclysis (distension of small bowel for visualization). A report suggested CT enteroclysis to be superior to conventional enteroclysis in evaluation of symptomatic Crohn's disease, especially for the detection of fistula, abscess, skip lesions, lymphadenopathy, and conglomeration of small bowel loops.
MR and CT versions exist.
X-ray
X-radiation is a form of electromagnetic radiation. X-rays have a wavelength in the range of 0.01 to 10 nanometers, corresponding to frequencies in the range 30 petahertz to 30 exahertz and energies in the range 120 eV to 120 keV. They are shorter in wavelength than UV rays and longer than gamma...
of the small intestine
Small intestine
The small intestine is the part of the gastrointestinal tract following the stomach and followed by the large intestine, and is where much of the digestion and absorption of food takes place. In invertebrates such as worms, the terms "gastrointestinal tract" and "large intestine" are often used to...
. Radiocontrast
Radiocontrast
Radiocontrast agents are a type of medical contrast medium used to improve the visibility of internal bodily structures in an X-ray based imaging techniques such as computed tomography or radiography...
is infused through a tube inserted through the nose to the duodenum
Duodenum
The duodenum is the first section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear and the terms anterior intestine or proximal intestine may be used instead of duodenum...
, and images are taken in real time as the contrast moves through aided by administration of methyl cellulose. Enteroclysis is also known by the confusing misnomer "Small bowel enema". 'Enema' is confusing as it suggests that the contrast material is introduced through the anal route.
It is the gold standard for evaluating small bowel diseases like Crohn's, though it has largely been replaced by CT enterography. CT enteroclysis is now available which combines the advantages of CT (ample extraluminal information and visualization) and conventional enteroclysis (distension of small bowel for visualization). A report suggested CT enteroclysis to be superior to conventional enteroclysis in evaluation of symptomatic Crohn's disease, especially for the detection of fistula, abscess, skip lesions, lymphadenopathy, and conglomeration of small bowel loops.
MR and CT versions exist.
Indications
- Apart from Crohn's disease as indicated above, enteroclysis is invaluable in small intestinal obstruction. In this condition it helps to distinguish the complete (which requires early operation) from the incomplete varieties of obstruction (or occlusion).
- Any suspicion of a large intestinal obstruction precludes an enteroclysis until the possibility has been excluded. If enteroclysis is conducted in a patient suspected of large bowel obstruction, the ileocecal valve will pump the contrast material into the dilated caecum which lies proximal to the obstruction in large intestine. This can cause a perforation.