CT enteroclysis (protocol)
Updates to Article Attributes
Computed tomographic (CT) enteroclysis refers to a hybrid technique that combines the methods of fluoroscopic intubation-infusion small-bowel bowel examinations with that of abdominal CT 1.
Indications
CT enteroclysis is complementary to capsule endoscopy in the elective investigation of small-bowel disease, with a specific role in the investigation of Crohn disease, small-bowel obstruction 1, 3, and unexplained gastrointestinal bleeding.
CT enteroclysis is thought to beconsidered significantly superior to conventional enteroclysis in depicting Crohn's disease-associated intra- and extra-mural abnormalities2.
Technique
CT enteroclysis utilises mainly two types of contrast :
-
neutral contrast media1, 5
- these have
attenuationattenuation similar to that of watere, e.g. water, methyl cellulose - intravenous contrast is used with neutral agents
- these agents allow better assessment of mucosal enhancement, mural thickness as well as mesenteric vasculature
- better used in unexplained subacute gastrointestinal bleeding due to vascular malformation and assessment of inflammatory activity and complications of small bowel Crohn’s disease
- these have
-
positive enteral contrast material1, 5
-
e.g. (4 to 15% water-soluble (sodium diatrizoate) solution or a
dilutedilute (1%) barium solution) - no intravenous contrast is used with these agents
- mainly used to detect lower grades of small bowel obstruction and internal fistula
-
e.g. (4 to 15% water-soluble (sodium diatrizoate) solution or a
Procedure
The technique of CT enteroclysis can be summarised and simplified as follows 1,5,8:
- Bowel preparation: low-residue diet, ample amount of fluids, laxative on the day prior to the examination, and nil by mouth on the day of the examination.
- Conscious sedation (optional, according to patient's preference)
- Introduction of the 12 to 14-F enteroclysis tube (under fluoroscopy or through duodenoscope). The tube tip is usually placed distal to the ligament of Treitz .
- Contrast is administered either on the fluoroscopy table or after transferring the the patient to the CT unit for commencement of the CT scan (usually 1.5-2L of oral contrast).
- In the CT unit, the position of the enteroclysis tube is checked in the topogram.
- In case negative oral contrast
willis to be be used, intravenous contrast injection will be given (approximately 100-150ml). - After completing the scan, the tube is withdrawn gradually to the stomach and any extra contrast volume is suctioned.
See also
-<p><strong>Computed tomographic (CT) enteroclysis</strong> refers to a hybrid technique that combines the methods of fluoroscopic intubation-infusion small-bowel examinations with that of abdominal CT <sup>1</sup>.</p><h4>Indications</h4><p>CT enteroclysis is complementary to <a href="/articles/capsule-endoscopy">capsule endoscopy</a> in the elective investigation of small-bowel disease, with a specific role in the investigation of <a href="/articles/crohn-disease-1">Crohn disease</a>, <a href="/articles/small-bowel-obstruction">small-bowel obstruction</a> <sup>1, 3</sup>, and unexplained gastrointestinal bleeding.</p><p>CT enteroclysis is thought to be significantly superior to conventional enteroclysis in depicting Crohn's disease-associated intra- and extra-mural abnormalities <sup>2</sup>.</p><h4>Technique</h4><p>CT enteroclysis utilises mainly two types of contrast :</p><ul>- +<p><strong>Computed tomographic (CT) enteroclysis</strong> refers to a hybrid technique that combines the methods of fluoroscopic intubation-infusion small bowel examinations with that of abdominal CT <sup>1</sup>.</p><h4>Indications</h4><p>CT enteroclysis is complementary to <a href="/articles/capsule-endoscopy">capsule endoscopy</a> in the elective investigation of small-bowel disease, with a specific role in the investigation of <a href="/articles/crohn-disease-1">Crohn disease</a>, <a href="/articles/small-bowel-obstruction">small-bowel obstruction</a> <sup>1, 3</sup>, and unexplained gastrointestinal bleeding.</p><p>CT enteroclysis is considered significantly superior to conventional enteroclysis in depicting Crohn disease-associated intra- and extra-mural abnormalities <sup>2</sup>.</p><h4>Technique</h4><p>CT enteroclysis utilises mainly two types of contrast :</p><ul>
-<strong>neutral contrast media </strong><sup>1, 5</sup><ul>-<li>these have attenuation similar to that of water e.g. water, methyl cellulose</li>- +<strong>neutral contrast media </strong><sup>1, 5</sup><ul>
- +<li>these have attenuation similar to that of water, e.g. water, methyl cellulose</li>
-<strong></strong>e.g. (4 to 15% water-soluble (<a href="/articles/sodium-diatrizoate">sodium diatrizoate</a>) solution or a dilute (1%) barium solution)</li>- +<strong></strong>e.g. (4 to 15% water-soluble (<a href="/articles/sodium-diatrizoate">sodium diatrizoate</a>) solution or a dilute (1%) barium solution)</li>
-<li>In case negative oral contrast will be used, intravenous contrast injection will be given (approximately 100-150ml).</li>- +<li>In case negative oral contrast is to be be used, intravenous contrast injection will be given (approximately 100-150ml).</li>
-<li><a title="Enteroclysis" href="/articles/enteroclysis">enteroclysis</a></li>- +<li><a href="/articles/enteroclysis">enteroclysis</a></li>