What is the role of enteroclysis in the workup of small-bowel obstruction (SBO)?

Updated: Apr 28, 2017
  • Author: Mityanand Ramnarine, MD, FACEP; Chief Editor: Steven C Dronen, MD, FAAEM  more...
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Answer

Enteroclysis is the use of a contrast agent normally administered through a nasogastric tube. Enteroclysis is valuable in detecting the presence of obstruction and in differentiating partial from complete blockages. This study is useful when plain radiographic findings are normal in the presence of clinical signs of small-bowel obstruction (SBO) or when plain radiographic findings are nonspecific. Enteroclysis is often less desirable when compared to computed tomography (CT) scanning due to the risk of perforation or aspiration with the administration of contrast medium. 

Enteroclysis distinguishes adhesions from metastases, tumor recurrence, and radiation damage. It offers a high negative predictive value and can be performed with 2 types of contrast agents. Barium is the classic contrast agent used in this study; it is safe and useful when diagnosing obstructions, provided that no evidence of bowel ischemia or perforation exists. Barium has been associated with peritonitis and should be avoided if perforation is suspected.


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