COMPUTED TOMOGRAPHIC ENTEROCLYSIS - ONE METHODOLOGY

RATIONALE AND OBJECTIVES. Computed tomography (CT) is limited in the a ssessment of partial small bowel obstruction (SBO). Enteroclysis is pr eferred but gives little direct information about the bowel wall, mese ntery, or remote findings. Preliminary results of a combined CT entero clysis (CT-E) methodology are reported. METHODS. Forty-eight patients with suspected partial SBO underwent a water soluble contrast enterocl ysis followed immediately by CT. Pump rates at fluoroscopy and CT were 75 to 100 cc/min unless a high-grade obstruction was encountered at f luoroscopy. Shrake's criteria for complete, high-grade or low-grade pa rtial SBO were used. RESULTS. The calculated dose per patient was 27 r ad for CT-E as opposed to 32 rad with traditional enteroclysis. Site s pecific sensitivity and specificity for low-grade partial SBO, were 82 .1% and 87.5%. One death was encountered in a patient with diffuse abd ominal metastatic disease and complete obstruction. This was caused by vomiting and aspiration secondary to tube placement alone, CT-enteroc lysis having been aborted. CONCLUSIONS. Computed tomographic enterocly sis is a diagnostic option for evaluation of low-grade partial SBOs. P itfalls with this technique are encountered in decompressed torsions a nd hernias.