Primary malignant tumors in the small bowel: a comparison of the small-bowel enema and conventional follow-through examination.

Of 71 patients diagnosed with primary mesenteric malignant tumors in the small bowel over a 21-year period in a community/teaching hospital, 14 underwent small-bowel follow-through, 16 underwent small-bowel enema (enteroclysis), and four patients underwent both studies preoperatively. In a retrospective study, the sensitivity of both the small-bowel enema and the conventional small-bowel follow-through examination were compared on the basis of the original radiologic interpretation. The studies were ordered by clinicians in a clinical setting. Results of the small-bowel follow-through were abnormal in 11 of 18 patients for a sensitivity of 61%, and small-bowel enema showed abnormalities in 19 of 20 patients for a sensitivity of 95% (p = .0165). The actual tumor was shown in six (33%) of 18 small-bowel follow-through studies and in 18 (90%) of 20 small-bowel enemas (p = .0005). In four patients, normal findings on conventional small-bowel follow-through were followed by abnormal findings on small-bowel enema done for the same reason. This experience suggests that the small-bowel enema is more sensitive than the conventional follow-through examination for the detection of small-bowel cancers.

Double-contrast barium enema study: simple conversion to CO2.

The use of CO2 instead of room air for double-contrast barium enema (DCBE) studies has been shown to decrease discomfort after the study. An inexpensive system assembled from materials currently used to perform pneumocolon examinations is described, which simplifies conversion to CO2 use for the DCBE study. No changes in currently used pneumocolon techniques are necessary with the use of CO2.