The diagnosis of intestinal obstruction by small bowel enterography through nasointestinal decompression tube / 中华普通外科杂志

ABSTRACT

Objective To study the clinical significance for the establishment of diagnosis of small bowel obstruction by selective small bowel enterography through a nasointestinal decompression tube. Methods Tirty-five patients with small bowel obstruction, with no strangulation or other contraindications, were intubated with a 300 cm nasointestinal decompression tube till upper jejunum under X-ray monitoring. The patients firstly underwent intra-small-intestinal suction therapy. When the tube reached the diseased region, a selective small bowel enterography was performed. Under X-ray inspection, 20-100 ml of 76% meglumine diatrizoatis and 50-200 ml of air were slowly injected via the decompression tube to perform double contrast intestinal radiography. Results Intubation was successful in all the 35 patients. Mter the small intestinal decompression therapy. Obstruction was cured in 20 cases, alleviated in 15 cases, and 10 cases received operation. Small bowel enterography in this series was all of high quality, there were 6 cases in which no abnormal X-ray findings, adhesive small bowel obstruction was suggested in 15 cases, small bowel tumor was identified in 4 cases (3 metastatic tumor, 1 small bowel cancer), small bowel Crohn's disease in 3 cases, radioactive enteritis in 3 cases, enteric intussusception in 2, polyp of the small intestine in one, and carcinoma of the ascending colon in one. Conclusions The nasointestinal decompression intubation with X-ray monitoring serves a dual function for the patients with intestinal obstruction, it decompresses the small bowel and does small intestinal radiography, in this way the locale of obstruction was found and the cause of the obstruction identified.