Small-bowel enema - An underutilized method of small-bowel examination

The results of 88 consecutive small-bowel enemas were compared retrospectively with the results of 52 routine small-bowel series and 50 barium enemas done in the same patients. Ninety-six percent of the diagnoses made by small-bowel enema were correct, as compared to only 65% made by routine small-bowel series. The incorrect studies were mostly false negatives and the abnormalities missed included regional enteritis, small-bowel obstruction, and intestinal lymphoma. The barium enema failed to achieve ileal reflux in 26% of patients and had a 23% false negative rate when reflux was achieved. Because small-bowel series as done by conventional methods was significantly less accurate, we believe small-bowel enema should be considered in patients with suspected small-bowel disease when other studies are negative.