Skip to main content
Top
Published in: Pediatric Radiology 5/2007

01-05-2007 | Original Article

Enteroclysis in older children and teenagers

Authors: Sebuh Kurugoglu, Ugur Korman, Ibrahim Adaletli, Dogan Selcuk

Published in: Pediatric Radiology | Issue 5/2007

Login to get access

Abstract

Background

Enteroclysis (EC) has been widely and successfully used for evaluation of the small bowel in adults for about 30 years. However, despite recently improved intubation and examination techniques, in many paediatric radiology centres it is still not the preferred conventional barium study for the evaluation of small bowel pathology in children.

Objective

To share our 10 years of experience and review the feasibility of EC in 83 older children and teenagers, in terms of both technique and pathological findings.

Materials and methods

Between 1996 and 2006, EC was performed by the standard technique described by Herlinger to 83 children between 7 and 18 years of age. The indication for the study was jointly decided by the paediatric radiologist and the clinician. None of the examinations was converted to follow-through studies because of patient refusal or technical failure. Morphological changes, mucosal abnormalities, luminal abnormalities, perienteric structures, the location of the disease, indirect findings regarding the bowel wall and functional information were evaluated.

Results

All the children tolerated the procedure without difficulty. Out of 83 patients, 63 had abnormal findings. The spectrum of diagnoses were Crohn disease (n = 23), nonspecific enteritis (n = 10), malabsorption (n = 8), intestinal tuberculosis (n = 6), intestinal lymphoma (n = 5), Peutz-Jegher syndrome (n = 3), adhesions (n = 2), Behçet disease (n = 2), back-wash ileitis due to ulcerative colitis (n = 2), common-variable immune deficiency (n = 1) and lymphangiectasis (n = 1).

Conclusion

EC can easily be performed in children over 7 years of age and when performed using a correct technique it shows high diagnostic performance without any complications in the evaluation of small bowel diseases in older children and teenagers.
Literature
1.
go back to reference Korman U, Kurugoglu S, Ogut G (2005) Conventional enteroclysis with complementary MR enteroclysis: a combination of small bowel imaging. Abdom Imaging 30:564–575PubMedCrossRef Korman U, Kurugoglu S, Ogut G (2005) Conventional enteroclysis with complementary MR enteroclysis: a combination of small bowel imaging. Abdom Imaging 30:564–575PubMedCrossRef
2.
go back to reference Kappler M, Krauss-Etschmann S, Diehl V et al (2006) Detection of secretory IgA antibodies against gliadin and human tissue transglutaminase in stool to screen for coeliac disease in children: validation study. Br Med J 332:213–214CrossRef Kappler M, Krauss-Etschmann S, Diehl V et al (2006) Detection of secretory IgA antibodies against gliadin and human tissue transglutaminase in stool to screen for coeliac disease in children: validation study. Br Med J 332:213–214CrossRef
3.
go back to reference Nolan DJ (2000) Enteroclysis of non-neoplastic disorders of the small intestine. Eur Radiol 10:342–353PubMedCrossRef Nolan DJ (2000) Enteroclysis of non-neoplastic disorders of the small intestine. Eur Radiol 10:342–353PubMedCrossRef
4.
go back to reference Nolan DJ, Trail JC (1997) The current role of the barium examination of the small intestine. Clin Radiol 52:809–820PubMedCrossRef Nolan DJ, Trail JC (1997) The current role of the barium examination of the small intestine. Clin Radiol 52:809–820PubMedCrossRef
5.
go back to reference Herlinger HA (1978) A modified technique for the double contrast small bowel enema. Gastrointest Radiol 3:201–207PubMedCrossRef Herlinger HA (1978) A modified technique for the double contrast small bowel enema. Gastrointest Radiol 3:201–207PubMedCrossRef
6.
go back to reference Ali SI, Carty HM (2000) Paediatric Crohn’s disease: a radiological review. Eur Radiol 10:1085–1094PubMedCrossRef Ali SI, Carty HM (2000) Paediatric Crohn’s disease: a radiological review. Eur Radiol 10:1085–1094PubMedCrossRef
7.
go back to reference Ott DJ, Chen YM, Gelfand DW et al (1985) Detailed per-oral small bowel examination vs. enteroclysis. Part II: radiographic accuracy. Radiology 155:31–34PubMed Ott DJ, Chen YM, Gelfand DW et al (1985) Detailed per-oral small bowel examination vs. enteroclysis. Part II: radiographic accuracy. Radiology 155:31–34PubMed
8.
go back to reference Toms AP, Barltrop A, Freeman AH (2001) A prospective randomised study comparing enteroclysis with small bowel follow-through examinations in 244 patients. Eur Radiol 11:1155–1160PubMedCrossRef Toms AP, Barltrop A, Freeman AH (2001) A prospective randomised study comparing enteroclysis with small bowel follow-through examinations in 244 patients. Eur Radiol 11:1155–1160PubMedCrossRef
9.
go back to reference Vallance R (1980) An evaluation of the small bowel enema based on an analysis of 350 consecutive examinations. Clin Radiol 31:227–232PubMedCrossRef Vallance R (1980) An evaluation of the small bowel enema based on an analysis of 350 consecutive examinations. Clin Radiol 31:227–232PubMedCrossRef
10.
go back to reference Ekberg O (1977) Crohn’s disease of the small bowel examined by double contrast technique: a comparison with oral technique. Gastrointest Radiol 1:355–359PubMedCrossRef Ekberg O (1977) Crohn’s disease of the small bowel examined by double contrast technique: a comparison with oral technique. Gastrointest Radiol 1:355–359PubMedCrossRef
11.
go back to reference Traill ZC, Nolan DJ (1995) Technical report: intubation fluoroscopy times using a new enteroclysis tube. Clin Radiol 50:339–340PubMedCrossRef Traill ZC, Nolan DJ (1995) Technical report: intubation fluoroscopy times using a new enteroclysis tube. Clin Radiol 50:339–340PubMedCrossRef
12.
go back to reference Herlinger H, Maglinte DT, Yao T (1999) Enteroclysis technique and variations. In: Herlinger H, Maglinte DT, Birnbaum BA (eds) Clinical imaging of the small intestine. Springer, New York, pp 95–123 Herlinger H, Maglinte DT, Yao T (1999) Enteroclysis technique and variations. In: Herlinger H, Maglinte DT, Birnbaum BA (eds) Clinical imaging of the small intestine. Springer, New York, pp 95–123
13.
go back to reference Engelholm L, DeToeuf J, Herlinger H et al (1989) Crohn’s disease of the small bowel. In: Herlinger H, Maglinte DD (eds) Clinical radiology of the small intestine. Saunders, Philadelphia, pp 295–334 Engelholm L, DeToeuf J, Herlinger H et al (1989) Crohn’s disease of the small bowel. In: Herlinger H, Maglinte DD (eds) Clinical radiology of the small intestine. Saunders, Philadelphia, pp 295–334
14.
go back to reference Cirillo LC, Camera L, Della Noce M et al (2000) Accuracy of enteroclysis in Crohn’s disease of the small bowel: a retrospective study. Eur Radiol 10:1894–1898PubMedCrossRef Cirillo LC, Camera L, Della Noce M et al (2000) Accuracy of enteroclysis in Crohn’s disease of the small bowel: a retrospective study. Eur Radiol 10:1894–1898PubMedCrossRef
15.
go back to reference Tuohy AM, O’Gorman M, Byington C et al (1999) Yersinia enterocolitis mimicking Crohn’s disease in a toddler. Pediatrics 104:36–39CrossRef Tuohy AM, O’Gorman M, Byington C et al (1999) Yersinia enterocolitis mimicking Crohn’s disease in a toddler. Pediatrics 104:36–39CrossRef
16.
go back to reference Bernstein CN, Boult IF, Greenberg HM et al (1997) A prospective randomized comparison between small bowel enteroclysis and small bowel follow-through in Crohn’s disease. Gastroenterology 1132:390–398CrossRef Bernstein CN, Boult IF, Greenberg HM et al (1997) A prospective randomized comparison between small bowel enteroclysis and small bowel follow-through in Crohn’s disease. Gastroenterology 1132:390–398CrossRef
17.
go back to reference Maglinte DD, Burney BT, Miller RE (1982) Lesions missed on small bowel follow-through: analysis and recommendations. Radiology 144:737–739PubMed Maglinte DD, Burney BT, Miller RE (1982) Lesions missed on small bowel follow-through: analysis and recommendations. Radiology 144:737–739PubMed
18.
go back to reference Hara AK (2005) Capsule endoscopy: the end of the barium small bowel examination? Abdom Imaging 30:179–183PubMedCrossRef Hara AK (2005) Capsule endoscopy: the end of the barium small bowel examination? Abdom Imaging 30:179–183PubMedCrossRef
19.
go back to reference Guilhon de Araujo Sant’Anna AM, Dubois J, Miron MC et al (2005) Wireless capsule endoscopy for obscure small bowel disorders: final results of the first pediatric controlled trial. Clin Gastroenterol Hepatol 3:264–270PubMedCrossRef Guilhon de Araujo Sant’Anna AM, Dubois J, Miron MC et al (2005) Wireless capsule endoscopy for obscure small bowel disorders: final results of the first pediatric controlled trial. Clin Gastroenterol Hepatol 3:264–270PubMedCrossRef
20.
go back to reference Arguelles-Arias F, Caundo A, Romero J et al (2004) The value of capsule endoscopy in pediatric patients with a suspicion of Crohn’s disease. Endoscopy 36:869–873PubMedCrossRef Arguelles-Arias F, Caundo A, Romero J et al (2004) The value of capsule endoscopy in pediatric patients with a suspicion of Crohn’s disease. Endoscopy 36:869–873PubMedCrossRef
21.
go back to reference Barth BA, Donovan K, Fox VL (2004) Endoscopic placement of the capsule endoscope in children. Gastrointest Endosc 60:818–821PubMedCrossRef Barth BA, Donovan K, Fox VL (2004) Endoscopic placement of the capsule endoscope in children. Gastrointest Endosc 60:818–821PubMedCrossRef
22.
go back to reference Barloon TJ, Lu CC, Honda H et al (1994) Does a normal small bowel enteroclysis exclude small-bowel disease? A long-term follow-up of consecutive normal studies. Abdom Imaging 19:113–115PubMedCrossRef Barloon TJ, Lu CC, Honda H et al (1994) Does a normal small bowel enteroclysis exclude small-bowel disease? A long-term follow-up of consecutive normal studies. Abdom Imaging 19:113–115PubMedCrossRef
23.
go back to reference Bender GN, Maglinte DD, Kloppel VR et al (1999) CT enteroclysis: a superfluous diagnostic procedure or valuable when investigating small bowel disease? AJR 172:373–378PubMed Bender GN, Maglinte DD, Kloppel VR et al (1999) CT enteroclysis: a superfluous diagnostic procedure or valuable when investigating small bowel disease? AJR 172:373–378PubMed
24.
go back to reference Thoeni RF, Gould RG (1991) Enteroclysis and small bowel series: comparison of radiation dose and examination time. Radiology 178:659–662PubMed Thoeni RF, Gould RG (1991) Enteroclysis and small bowel series: comparison of radiation dose and examination time. Radiology 178:659–662PubMed
25.
26.
go back to reference Maglinte DD (2006) Small bowel imaging: a rapidly changing field and a challenge to radiology. Eur Radiol 16:967–971PubMedCrossRef Maglinte DD (2006) Small bowel imaging: a rapidly changing field and a challenge to radiology. Eur Radiol 16:967–971PubMedCrossRef
27.
go back to reference Brizi MG, Minordi LM, Mirk P et al (2002) The state of the art of small bowel imaging: combine the old with the new. Rays 27:51–65PubMed Brizi MG, Minordi LM, Mirk P et al (2002) The state of the art of small bowel imaging: combine the old with the new. Rays 27:51–65PubMed
28.
go back to reference Minordi LM, Vecchioli A, Guidi L et al (2006) Multidetector CT enteroclysis versus barium enteroclysis with methylcellulose in patients with suspected small bowel disease. Eur Radiol 16:1527–1536PubMedCrossRef Minordi LM, Vecchioli A, Guidi L et al (2006) Multidetector CT enteroclysis versus barium enteroclysis with methylcellulose in patients with suspected small bowel disease. Eur Radiol 16:1527–1536PubMedCrossRef
Metadata
Title
Enteroclysis in older children and teenagers
Authors
Sebuh Kurugoglu
Ugur Korman
Ibrahim Adaletli
Dogan Selcuk
Publication date
01-05-2007
Publisher
Springer-Verlag
Published in
Pediatric Radiology / Issue 5/2007
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-007-0435-z

Other articles of this Issue 5/2007

Pediatric Radiology 5/2007 Go to the issue