Suspected Small-Bowel Obstruction To our knowledge; however, CT enteroclysis is not widely used in the United States at present, especially for acute presentations of bowel obstruction. CT Enterography CT enterography does not require intubation of the small-bowel but instead relies on large volumes of orally ingested contrast in a set time interval. In the setting of suspected obstruction of this clinical scenario, patients cannot generally tolerate the oral contrast administration requirements. As in the case of CT enteroclysis, the use in the acute patient presentation is not favorable because of a lack of tolerance to ingest a relatively large volume of fluid if the bowel is obstructed. Fluoroscopy Small Bowel Enteroclysis There is solid evidence that enteroclysis is highly reliable in revealing sites of low- and high-grade SBO [62,63], as well as for distinguishing adhesions from obstructing neoplasms or other etiologies [62]. Despite this evidence, enteroclysis is not useful in the acute situation of suspected obstruction in which the patient is ill. In this clinical scenario, such patients cannot tolerate the invasive nature of the examination. Fluoroscopy Small Bowel Follow-Through Opinions remain divided on the usefulness of SBFT examinations with an orally administered barium contrast or water-soluble contrast. Some investigators have found this examination useful for managing suspected SBO in 68% to 100% of cases [64]. However, the ability to diagnose ischemic loops or bowel perforation can be limited. SBFT does not typically evaluate for other etiologies of abdominal pain that may be detected on CT. As such, the SBFT could be considered a problem-solving examination following an equivocal CT, particularly with suspected low- grade or intermittent or partial obstruction [65]. Early reports of possible therapeutic benefits of the use of water- soluble contrast agents in patients with postoperative SBO remain controversial and uncertain [14-16].
Suspected Small Bowel Obstruction. Suspected Small-Bowel Obstruction To our knowledge; however, CT enteroclysis is not widely used in the United States at present, especially for acute presentations of bowel obstruction. CT Enterography CT enterography does not require intubation of the small-bowel but instead relies on large volumes of orally ingested contrast in a set time interval. In the setting of suspected obstruction of this clinical scenario, patients cannot generally tolerate the oral contrast administration requirements. As in the case of CT enteroclysis, the use in the acute patient presentation is not favorable because of a lack of tolerance to ingest a relatively large volume of fluid if the bowel is obstructed. Fluoroscopy Small Bowel Enteroclysis There is solid evidence that enteroclysis is highly reliable in revealing sites of low- and high-grade SBO [62,63], as well as for distinguishing adhesions from obstructing neoplasms or other etiologies [62]. Despite this evidence, enteroclysis is not useful in the acute situation of suspected obstruction in which the patient is ill. In this clinical scenario, such patients cannot tolerate the invasive nature of the examination. Fluoroscopy Small Bowel Follow-Through Opinions remain divided on the usefulness of SBFT examinations with an orally administered barium contrast or water-soluble contrast. Some investigators have found this examination useful for managing suspected SBO in 68% to 100% of cases [64]. However, the ability to diagnose ischemic loops or bowel perforation can be limited. SBFT does not typically evaluate for other etiologies of abdominal pain that may be detected on CT. As such, the SBFT could be considered a problem-solving examination following an equivocal CT, particularly with suspected low- grade or intermittent or partial obstruction [65]. Early reports of possible therapeutic benefits of the use of water- soluble contrast agents in patients with postoperative SBO remain controversial and uncertain [14-16].