Crohn disease of the small bowel: Spiral CT evaluation after oral hyperhydration with isotonic solution

Purpose: Our aim was to evaluate the accuracy of spiral CT study of small-b owel Crohn disease with use of oral hyperhydration with isoosmotic solution . Method: We prospectively analyzed 33 consecutive patients and 10 control su bjects with spiral CT after oral administration of 2,000 mi of polyethylene glycol electrolyte-balanced solution. The CT diagnoses were compared with the results of conventional radiologic oral barium examination (33 cases), ileum colonoscopy (8 cases), and surgery (4 cases). Results: The final diagnoses were Crohn disease (14 cases), no small-bowel disease (16 cases), cancer of ileocecal valve (1 case), carcinosis of mesen teric root (1 case), and intestinal lymphangiectasia (1 case). In the contr ol group, no abnormalities of the small bowel were found. The sensitivity o f spiral CT was 85.7%, specificity 100%, positive predictive value 100%, ne gative predictive value 90%, and diagnostic accuracy 93.9%. Conclusion: Our method allowed adequate distension of the small bowel for s piral CT studies, thus resulting in a safe and effective alternative to sma ll-bowel spiral CT enema, which can be used in patients that refuse the nas ojejunal balloon catheter.