The use of non-ionic water-soluble contrast agents for small bowel follow-through examination

In certain situations it is preferable to perform small bowel examination u sing water-soluble contrast agents. Generally, ionic agents are used, but n on-ionic agents may be an alternative in certain circumstances. We retrospe ctively reviewed a consecutive series of small bowel examinations using non -ionic media in order to determine their efficacy. A total of 52 water-solu ble non-ionic small bowel follow-through examinations were performed in 42 patients using 100 ml iohexol. Indications for the study and the reasons wh y barium sulphate suspensions were contraindicated were established. Studie s were assessed for radiographic quality and clinical findings were noted, and comparison was made with operative findings and clinical outcome. Obstr uction was diagnosed in 12 examinations and the radiological findings were confirmed in all 7 patients surgically treated. Fistulae were identified in 11 examinations and the radiological findings were confirmed in all 8 pati ents who were treated by laparotomy. Additionally, at laparotomy no obstruc tion or fistula was found in the 5 patients in whom prior contrast examinat ion had been negative. Non-ionic water-soluble follow-through examination i s easily performed and well tolerated, allowing accurate diagnosis of obstr uction and fistula when barium suspensions are contraindicated.