CT enteroclysis (protocol)
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Computed tomographic (CT) enteroclysis refers to a hybrid technique that combines the methods of fluoroscopic intubation-infusion small-bowel examinations with that of abdominal CT 1.
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 be significantly superior to conventional enteroclysis in depicting Crohn's disease-associated intra- and extramural abnormalities 2.
CT enteroclysis utilisesutilizes mainly two types of contrast:
-
neutral contrast media
:1,5- these have attenuation similar to that of water 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
-
positive enteral contrast material1,5
-
e.g. (4 to 15% water-soluble
(sodium(sodium diatrizoate) solution or a dilute (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
The technique of CT enteroclysis can be summarized 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 will)
- introduction of the 12 to 14-F enteroclysis tube (under fluoroscopy or through duodenosocope). 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 1.5-2 Liters of oral contrast).
- in the CT unit, the position of the enteroclysis tube is checked in the topogram.
- in case negative oral contrast will be used, intravenous contrast injection will be given (approximately 100-150ml).
- after completing the scan, the tube is withdrawn gradually to the stomach and the extra amount of contrast is suctioned.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><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/crohns-disease-4">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 extramural abnormalities <sup>2</sup>.</p><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><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/crohns-disease-4">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 extramural abnormalities <sup>2</sup>.</p><p>CT enteroclysis utilizes mainly two types of contrast :</p><ul>
-<strong>neutral contrast media</strong>:<ul>- +<strong>neutral contrast media </strong><sup>1,5</sup><ul>
-<li>better used in unexplained subacute gastrointestinal bleeding due to vascular malformation and assessment of inflammatory activity and complications of small bowel <a href="/articles/crohns-disease-4">Crohn’s disease</a>- +<li>better used in unexplained subacute gastrointestinal bleeding due to vascular malformation and assessment of inflammatory activity and complications of small bowel <a href="/articles/crohn-s-disease">Crohn’s disease</a>
-<strong>positive enteral contrast material</strong><ul>- +<strong>positive enteral contrast material<sup> </sup></strong><sup>1,5</sup><ul>
-<strong></strong>e.g. (4 to 15% water-soluble (sodium diatrizoate) 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>
-</ul><h4>See also</h4><ul>- +</ul><p>The technique of CT enteroclysis can be summarized and simplified as follows <sup>1,5,8 </sup>:</p><ol>
- +<li>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.</li>
- +<li>conscious sedation (optional, according to patient’s will)</li>
- +<li> introduction of the 12 to 14-F enteroclysis tube (under fluoroscopy or through duodenosocope). The tube tip is usually placed distal to the ligament of Treitz .</li>
- +<li>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 1.5-2 Liters of oral contrast).</li>
- +<li>in the CT unit, the position of the enteroclysis tube is checked in the topogram.</li>
- +<li>in case negative oral contrast will be used, intravenous contrast injection will be given (approximately 100-150ml).</li>
- +<li>after completing the scan, the tube is withdrawn gradually to the stomach and the extra amount of contrast is suctioned.</li>
- +</ol><h4>See also</h4><ul>
References changed:
- 8. Kołodziej M, Annabhani A, Sąsiadek M. CT enteroclysis in the diagnostics of small bowel diseases. Pol J Radiol. 2012;75 (2): 66-72. <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3389868">Free text at pubmed</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/22802779">Pubmed citation</a><span class="auto"></span>
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