methylcellulose and Gastrointestinal-Hemorrhage

Topics: Contrast Media; Gastrointestinal Hemorrhage; Humans; Male; Meckel Diverticulum; Methylcellulose; Middle Aged; Tomography, X-Ray Computed

Our objective was a prospective comparison of MR enteroclysis (MRE) with multidetector spiral-CT enteroclysis (MSCTE). Fifty patients with various suspected small bowel diseases were investigated by MSCTE and MRE. The MSCTE was performed using slices of 2.5 mm, immediately followed by MRE, obtaining T1- and T2-weighted sequences, including gadolinium-enhanced acquisition with fat saturation. Three radiologists independently evaluated MSCTE and MRE searching for 12 pathological signs. Interobserver agreement was calculated. Sensitivities and specificities resulted from comparison with pathological results ( n=29) and patient's clinical evolution ( n=21). Most pathological signs, such as bowel wall thickening (BWT), bowel wall enhancement (BWE) and lymphadenopathy (ADP), showed better interobserver agreement on MSCTE than on MRE (BWT: 0.65 vs 0.48; BWE: 0.51 vs 0.37; ADP: 0.52 vs 0.15). Sensitivity of MSCTE was higher than that of MRE in detecting BWT (88.9 vs 60%), BWE (78.6 vs 55.5%) and ADP (63.8 vs 14.3%). Wilcoxon signed-rank test revealed significantly better sensitivity of MSCTE than that of MRE for each observer ( p=0.028, p=0.046, p=0.028, respectively). Taking the given study design into account, MSCTE provides better sensitivity in detecting lesions of the small bowel than MRE, with higher interobserver agreement.

Topics: Artifacts; Contrast Media; Enema; Female; Gadolinium DTPA; Gastrointestinal Hemorrhage; Humans; Inflammatory Bowel Diseases; Injections, Intravenous; Intestinal Diseases; Intestine, Small; Magnetic Resonance Imaging; Male; Methylcellulose; Middle Aged; Observer Variation; Postoperative Complications; Prospective Studies; Sensitivity and Specificity; Tomography, Spiral Computed

The diagnostic value of enteroclysis in patients with obscure gastrointestinal bleeding of small bowel origin was evaluated. Further diagnostic approaches in patients in whom enteroclysis did not yield a source for bleeding are discussed.. A total of 62 patients with gastrointestinal bleeding of obscure origin were retrospectively evaluated by enteroclysis. Patients in whom a specific pathology could not be identified on enteroclysis were further followed-up clinically and by laboratory examinations. Recurrent gastrointestinal bleeding had been considered an indication for further diagnostic evaluation.. Accurate cause of the pathology which may explain the source of bleeding was achieved via enteroclysis in 29 of the patients. Of the pathologies, most were inflammatory bowel disease (n=18), followed by neoplasms (n=4), malabsorption (n=3) and miscellaneous disorders (n=4). Thirty-three patients had normal findings on enteroclysis. Six patients were diagnosed as angiodysplasia on angiography and nine patients had either gastritis or duodenitis. A final diagnosis to explain the source of bleeding could not be achieved in 18 cases.. Enteroclysis provides essential information in gastrointestinal bleeding of obscure origin and its role in the diagnosis should not be undermined. Recurrent and consistent GI bleeding should be considered an indication for further diagnostic evaluation.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Barium Sulfate; Female; Gastrointestinal Hemorrhage; Humans; Intestinal Diseases; Intestine, Small; Male; Methylcellulose; Middle Aged; Radiography; Reproducibility of Results; Retrospective Studies; Young Adult

The diagnostic yield of enteroclysis was retrospectively evaluated for patients with obscure bleeding from the gastrointestinal tract.. A total of 128 patients with obscure gastrointestinal bleeding were referred to our department for enteroclysis between 1988 and 1993. The original radiologic reports were reviewed to determine the radiographic findings in these patients. The radiographic findings then were correlated with medical, surgical, and pathologic findings.. Thirty-two patients had lesions found at enteroclysis. Nineteen of those patients had confirmation of the radiographic diagnosis, primarily by pathologic examination of the surgical specimen. Five other patients were found at surgery to have had false-positive diagnoses at enteroclysis. Eight patients ceased to bleed without pathologic corroboration, but their clinical presentation and course supported the radiographic diagnosis. Thus, 27 (21%) of the 128 patients had confirmed or highly probable lesions seen at enteroclysis as the cause of obscure gastrointestinal bleeding. Seventeen patients (13%) had tumors involving the small bowel, and three (2%) had arteriovenous malformations in the jejunum.. This study corroborates earlier reports that enteroclysis is a useful diagnostic test for examining the small intestine in patients with obscure gastrointestinal bleeding.

Topics: Adult; Aged; Aged, 80 and over; Barium Sulfate; Enema; Female; Gastrointestinal Hemorrhage; Humans; Intestinal Neoplasms; Intestine, Small; Male; Methylcellulose; Middle Aged; Radiography; Retrospective Studies

The authors describe a technique for obtaining a double-contrast hypotonic duodenogram after a small-bowel enema examination. They have used this technique successfully in patients with unexplained gastrointestinal bleeding and to assess duodenal involvement in patients with Crohn's disease.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Barium Sulfate; Contrast Media; Crohn Disease; Duodenal Neoplasms; Duodenum; Enema; Gastrointestinal Hemorrhage; Humans; Hypotonic Solutions; Methylcellulose; Middle Aged; Radiography

One hundred twenty-five consecutive enteroclysis studies performed for the indication of gastrointestinal bleeding were reviewed. The overall yield of positive studies was low (10%) but important lesions were found. Patients with unequivocally normal evaluations of the upper gastrointestinal tract and colon had the highest yield of positive enteroclysis studies (20%). Neither the specific type of bleeding, the presence or absence of abdominal symptoms or physical examination findings, nor the results of laboratory tests were associated with a positive or negative enteroclysis study.

Topics: Angiography; Barium Sulfate; Endoscopy; Enema; Gastrointestinal Hemorrhage; Humans; Intestinal Diseases; Methylcellulose; Radionuclide Imaging

Topics: Animals; Aspirin; Drug Synergism; Gastric Mucosa; Gastrointestinal Hemorrhage; Hemostatics; Male; Methylcellulose; Rats; Time Factors