RESUMO
PURPOSE: This article gives an overview of the possibilities of conventional radiography in the diagnosis of inflammatory bowel disease of the small intestine and colon. MATERIAL AND METHODS: For more than 25 years we examine the small bowel employing enteroclysis with barium and methylcellulose and the colon with the usual double-contrast method. In the last 152 months 1560 small bowel enemas were performed. In the last 40 months 410 examinations of the colon were performed. RESULTS: There is a thirty percent decrease in enteroclysis examinations within the past 5 years,however, the rate of examinations with positive results increased from 46 to 57%. The proportion of the inflammatory small intestinal diseases (not only Crohn's disease) remained constant with 18%.Concerning the examinations of the colon for inflammatory disease we confirmed the diagnosis in seven cases. The radiation exposure for the enteroclysis in inflammatory diseases was 7 mSv, for colon examinations 14 mSv. CONCLUSION: Barium examinations, especially of the stomach and colon are decreasing in frequency. Therefore the art of performance and interpretation might get lost.Enteroclysis, however, is still the method of reference for the other imaging methods. The advantages compared to the other imaging methods are the excellent presentation of the details of the mucosal surface and the observation of functional disorders.
Assuntos
Sulfato de Bário , Meios de Contraste , Enema , Doenças Inflamatórias Intestinais/diagnóstico por imagem , Colite Ulcerativa/complicações , Colite Ulcerativa/diagnóstico por imagem , Doença de Crohn/complicações , Doença de Crohn/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Doenças do Íleo/diagnóstico por imagem , Metilcelulose/administração & dosagem , Radiografia , Fatores de Tempo , Tuberculose Gastrointestinal/diagnóstico por imagemAssuntos
Doença de Crohn/diagnóstico por imagem , Sulfato de Bário , Criança , Meios de Contraste , Enema , Humanos , RadiografiaRESUMO
Among the many inflammatory diseases of the colon, Crohn's disease and ulcerative colitis occur most frequently. For primary evaluation, endoscopy has widely replaced the barium enema (BE) as diagnostic method. BE, however can provide important additional informations in the differential diagnosis of chronic inflammatory colonic diseases. Purpose of this article is the demonstration of typical, but also of atypical radiological changes in different stages of Crohn's disease and ulcerative colitis, as well as calling attention to the importance of CT. A BE demands a refined examination technique using double contrast. All CT-examinations have to be scrutinized for changes of the bowel and mesentery. A dedicated spiral-CT examination might be indicated in a known disease in order to obtain special informations. The advantage of a BE over endoscopy is a clear and reproducible demonstration of the patterns of distribution and character of the disease as well as the detection of fistulae. The classification into one or the other disease entity can be better accomplished. CT is superior in detecting bowel wall thickening, extraintestinal disease and complications. In diagnostic imaging of chronic inflammatory bowel diseases, endoscopy and radiologic techniques are used complementarily.
Assuntos
Colite Ulcerativa/diagnóstico por imagem , Doença de Crohn/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Sulfato de Bário , Colite Ulcerativa/complicações , Colonoscopia , Meios de Contraste , Doença de Crohn/complicações , Enema , Humanos , Sensibilidade e EspecificidadeRESUMO
The purpose of this work was to assess retrospectively the yield of enteroclysis in 124 unselected patients presenting with obscure gastrointestinal bleeding. Of 1000 consecutive patients who were examined by enteroclysis 124 presented with occult gastrointestinal bleeding. A total of 61 patients with an unknown source of bleeding at the time of discharge, but with established gastrointestinal bleeding, were followed up by questionnaire to correlate the initial degree of bleeding with the incidence of recurrence of bleeding. Enteroclysis was normal in 109 cases. An abnormality was found subsequently be the cause of bleeding in the small intestine in 16 patients. Enteroclysis was positive in 14 cases, negative in 2 and false positive in 1. There was positive correlation between the initial degree of haemorrhage and the rate of recurrence. Enteroclysis detected the cause in 11% of patients who presented with bleeding of unknown origin. In patients with minor haemorrhage there was no recurrence of bleeding in most cases.
Assuntos
Sulfato de Bário , Enema , Hemorragia Gastrointestinal/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Intestino Delgado/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , RadiografiaRESUMO
A modification of the small-bowel enema with barium and methylcellulose is described and findings in 300 consecutive examinations compared with the clinical diagnoses. The radiograph was positive in 37% of cases and the clinical examination in 29%. Diseases and abnormalities of the small bowel, including motility disorders, can be diagnosed with high sensitivity and specificity using this technique.
Assuntos
Sulfato de Bário , Enteropatias/diagnóstico por imagem , Intestino Delgado/diagnóstico por imagem , Metilcelulose , Adenocarcinoma/diagnóstico por imagem , Adulto , Doença Celíaca/diagnóstico por imagem , Doença de Crohn/diagnóstico por imagem , Estudos de Avaliação como Assunto , Motilidade Gastrointestinal , Humanos , Neoplasias Intestinais/diagnóstico por imagem , Neoplasias Intestinais/secundário , Obstrução Intestinal/diagnóstico por imagem , Métodos , RadiografiaRESUMO
The radiologic findings on small bowel enema examination using barium and methylcellulose (SBE + Ba + MC) in a patient with Whipple's disease before and after treatment are described. The changes on SBE + Ba + MC corresponded well to the clinical and morphologic picture. The advantages of this double contrast technique compared to the enteroclysis with barium alone are demonstrated. The SBE + Ba + MC is a good method to demonstrate the manifestations of Whipple's disease involving the small bowel and the mesentery.
Assuntos
Sulfato de Bário , Metilcelulose , Doença de Whipple/diagnóstico por imagem , Enema , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Tecnologia RadiológicaRESUMO
A modified technique of the small bowel enema is described. Diluted barium followed by an aqueous suspension of 0.5% methylcellulose is injected through a duodenal tube. Pathologic findings can be better recognized by the resulting double-contrast images than by other techniques. A detailed description of this method, and of our own experience, is given.