LESSON 11
DIAGNOSTIC RADIOLOGY OF INTESTINES AND COLON
SMALL INTESTINE. RADIOLOGICAL INVESTIGATION.
Plain abdominal radiographs and barium studies are the principal radiological
techniques used for the diagnosis and evaluation of disorders of the small intestine
though angiography, radionuclide studies and computed tomography (CT) can be
of value in certain selected cases. Ultrasound has a very limited role, and water-
soluble contrast examination has few practical applications.
PLAIN RADIOGRAPHS
Patients who present acutely with suspected perforation or obstruction of the small
intestine are investigated initially with plain abdominal radiographs. These films
are important for diagnose of intestinal obstruction. Visualization of Cloyber cups
is X ray sign in these cases. The big width size of cusps and localization of them in
the central abdomen are radiological signs of intestinal obstruction.
Barium follow-through examination
The barium follow-through is performed following a barium meal examination of
the oesophagus, stomach, and duodenum. As the barium column progresses
through the small intestine large radiographs of the abdomen are taken at intervals.
The first radiograph is taken with the patient supine about 15 minutes after the
barium meal and shows the proximal jejunum. The remaining radiographs are
normally taken at half-hourly intervals with the patient prone. When the barium
column reaches the caecum, spot views of the terminal ileum are taken.
It takes from 2 to 6 hours for the head of the barium column to reach the caecum.
The transit time of barium through the small intestine can be reduced by
preliminary cleansing of the colon or by the use of pharmacological agents.
Decreasing the transit time, however, results in diminished anatomical detail of the
small intestine, particularly the terminal ileum. The radiographic sign of intestinal
tumors is filling defect of contrast agent.
COMPUTED TOMOGRAPHY (CT)
Computed tomography (CT) is playing an increasing role in the radiological
evaluation of the small intestine. CT can provide useful information about the
extraluminal component of intestinal disorders, the relationship of adjacent organs
and tissues, and ancillary intra-abdominal findings. It is invaluable for diagnosing
intestinal infarction and in the diagnosis of intestinal obstruction. It is also useful in
the management of suspected complications of Crohn’s disease and for assessing
the extent of neoplasms involving the small intestine.
DIAGNOSTIC RADIOLOGY OF INTESTINES AND COLON
SMALL INTESTINE. RADIOLOGICAL INVESTIGATION.
Plain abdominal radiographs and barium studies are the principal radiological
techniques used for the diagnosis and evaluation of disorders of the small intestine
though angiography, radionuclide studies and computed tomography (CT) can be
of value in certain selected cases. Ultrasound has a very limited role, and water-
soluble contrast examination has few practical applications.
PLAIN RADIOGRAPHS
Patients who present acutely with suspected perforation or obstruction of the small
intestine are investigated initially with plain abdominal radiographs. These films
are important for diagnose of intestinal obstruction. Visualization of Cloyber cups
is X ray sign in these cases. The big width size of cusps and localization of them in
the central abdomen are radiological signs of intestinal obstruction.
Barium follow-through examination
The barium follow-through is performed following a barium meal examination of
the oesophagus, stomach, and duodenum. As the barium column progresses
through the small intestine large radiographs of the abdomen are taken at intervals.
The first radiograph is taken with the patient supine about 15 minutes after the
barium meal and shows the proximal jejunum. The remaining radiographs are
normally taken at half-hourly intervals with the patient prone. When the barium
column reaches the caecum, spot views of the terminal ileum are taken.
It takes from 2 to 6 hours for the head of the barium column to reach the caecum.
The transit time of barium through the small intestine can be reduced by
preliminary cleansing of the colon or by the use of pharmacological agents.
Decreasing the transit time, however, results in diminished anatomical detail of the
small intestine, particularly the terminal ileum. The radiographic sign of intestinal
tumors is filling defect of contrast agent.
COMPUTED TOMOGRAPHY (CT)
Computed tomography (CT) is playing an increasing role in the radiological
evaluation of the small intestine. CT can provide useful information about the
extraluminal component of intestinal disorders, the relationship of adjacent organs
and tissues, and ancillary intra-abdominal findings. It is invaluable for diagnosing
intestinal infarction and in the diagnosis of intestinal obstruction. It is also useful in
the management of suspected complications of Crohn’s disease and for assessing
the extent of neoplasms involving the small intestine.
