Fluoroscopy Contrast Enema Colonoscopy is the most useful modality for evaluation of the colon in patients with suspected or known Crohn disease involving the colon [2]. Fluoroscopy contrast enema is uncommonly used in current practice. An institutional study confirmed this decline in which the average number of contrast enema per Crohn disease patients per year dropped from 0.05 in 2001 to 0.01 in 2010 [20]. Fluoroscopy contrast enema, however, may remain an option if selected problem solving is necessary, such as stricture assessment during contrast injection [21]. Fluoroscopy Upper GI Series with Small Bowel Follow-Through Using fluoroscopy small bowel follow-through (SBFT) with barium is a historically well-established modality for small bowel evaluation [2]. There is, however, a significant decrease in use of SBFT with current widespread use of cross-sectional imaging modalities including MRI and CT. Although fluoroscopy SBFT allows accurate intraluminal and mucosal assessment, bowel wall thickness among other signs cannot be directly visualized. Additionally, although internal fistulas may be visualized, extraluminal pathologies including abscess formation may only be indirectly inferred. In a study of 87 pediatric patients with IBD utilization histology as criterion standard, 31% of patients had pathology identified on MRI not visualized on SBFT. In this study, the SBFT sensitivity and specificity were 76% and 67%, respectively, whereas MRI demonstrated greater sensitivity and specificity of 83% and 95%, respectively [22]. Fluoroscopy SBFT, however, does remain an option if problem solving is necessary, such as cutaneous fistula evaluation [21]. Fluoroscopy SBFT may also serve as an alternative to MRI and CT to avoid sedation, particularly in younger children. Crohn Disease-Child
Crohn Disease Child. Fluoroscopy Contrast Enema Colonoscopy is the most useful modality for evaluation of the colon in patients with suspected or known Crohn disease involving the colon [2]. Fluoroscopy contrast enema is uncommonly used in current practice. An institutional study confirmed this decline in which the average number of contrast enema per Crohn disease patients per year dropped from 0.05 in 2001 to 0.01 in 2010 [20]. Fluoroscopy contrast enema, however, may remain an option if selected problem solving is necessary, such as stricture assessment during contrast injection [21]. Fluoroscopy Upper GI Series with Small Bowel Follow-Through Using fluoroscopy small bowel follow-through (SBFT) with barium is a historically well-established modality for small bowel evaluation [2]. There is, however, a significant decrease in use of SBFT with current widespread use of cross-sectional imaging modalities including MRI and CT. Although fluoroscopy SBFT allows accurate intraluminal and mucosal assessment, bowel wall thickness among other signs cannot be directly visualized. Additionally, although internal fistulas may be visualized, extraluminal pathologies including abscess formation may only be indirectly inferred. In a study of 87 pediatric patients with IBD utilization histology as criterion standard, 31% of patients had pathology identified on MRI not visualized on SBFT. In this study, the SBFT sensitivity and specificity were 76% and 67%, respectively, whereas MRI demonstrated greater sensitivity and specificity of 83% and 95%, respectively [22]. Fluoroscopy SBFT, however, does remain an option if problem solving is necessary, such as cutaneous fistula evaluation [21]. Fluoroscopy SBFT may also serve as an alternative to MRI and CT to avoid sedation, particularly in younger children. Crohn Disease-Child