Computed tomographic (CT) enteroclysis refers to a hybrid technique that combines the methods of fluoroscopic intubation-infusion small bowel examinations with that of abdominal CT.
CT enteroclysis is complementary to capsule endoscopy in the elective investigation of small-bowel disease, with a specific role in the investigation of Crohn disease, small-bowel obstruction , and unexplained gastrointestinal bleeding.
CT enteroclysis is considered significantly superior to conventional enteroclysis in depicting Crohn disease-associated intra- and extra-mural abnormalities .
CT enteroclysis utilizes mainly two types of contrast:
- neutral contrast media
- these have attenuation similar to that of water, e.g. water, methylcellulose
- intravenous contrast is used with neutral agents
- these agents allow better assessment of mucosal enhancement, mural thickness as well as mesenteric vasculature
- better used in unexplained subacute gastrointestinal bleeding due to vascular malformation and assessment of inflammatory activity and complications of small bowel Crohn disease
- positive enteral contrast material
- e.g. 4 to 15% water-soluble (sodium diatrizoate) solution or a dilute (1%) barium solution
- no intravenous contrast is used with these agents
- mainly used to detect lower grades of small bowel obstruction and internal fistula
The technique of CT enteroclysis can be summarized and simplified as follows :