Sonoenteroclysis, a new sonographic method in evaluating and diagnosing small bowel disorders is an effective alternative to the usual method of barium enteroclysis, according to a recent study conducted by researchers at the Postgraduate Institute of Medical Education and Research in Chandigarh, India. Sonoenteroclysis is a new way of doing transabdominal ultrasound. Patients are given fluid through the nasojejunal tube in order to alleviate gas in the bowel.
Various techniques available until now for evaluating the small bowel have been either inadequate or have various disadvantages and limitations, said Birinder Nagi, MD, lead author of the study. Radiologic evaluation of the small bowel is usually done by barium examination which cannot evaluate the bowel wall and surrounding structures. With CT enteroclysis, another method, mucosal details cannot be well seen. Both of these techniques are associated with increased exposure to radiation. PET-CT enteroclysis is a new promising technique, but also requires ionizing radiation. MR enteroclysis is not widely available and there is concern about patients vomiting in the gantry while they are undergoing the examination.
The study consisted of 50 patients with suspected small bowel disorder who underwent sonoenteroclysis followed by barium enteroclysis. The findings of the two were compared. The researchers noted small bowel thickness, luminal diameter, peristalsis and extra intestinal lesions. Of the 50 patients, 10 showed normal small bowel on both sonoenteroclysis and barium enteroclysis. The study also showed that 25 of the remaining 40 patients showed abnormality in the form of: strictures, dilated loops, thickened folds, mass lesions, etc. on both techniques as well. Additional findings on sonoenteroclysis were thickened bowel wall with loss of stratification, ascites, and lymphadenopathy. These were later diagnosed as cases of tuberculosis.
The results of sonoenteroclysis were comparable to barium enteroclysis and also provided additional information regarding bowel wall and surrounding structures, said Dr. Nagi. This examination is simple, non-invasive, without radiation, cheap and can be used as an initial investigation in patients with suspected small bowel diseases, he said.
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