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.