7023 Enteroclysis in the evaluation of unexplained chronic abdominal pain.

Abstract

Purpose: The purpose of this study was to evaluate the utility of enteroclysis (dedicated small bowel radiography) in the evaluation of chronic abdominal pain. Methods:A retrospective review of 34 consecutive patients was done at Temple University Hospital (mean age of 42 years, 17 males and 17 females) who had undergone enteroclysis for evaluation of chronic abdominal pain. All patients were initially worked up with EGD and colonoscopy, and when these tests did not reveal a source for the chronic abdominal pain an enteroclysis was performed. Results:4/34(12%) of the patients had an abnormal enteroclysis study. These patients included 2 with small bowel patterns consistant with adhesions, 1 with dilitation of the proximal duodenum consistant with superior mesenteric artery syndrome and 1 with ulceration in the ileum consistant with Crohns ileitis. Conclusions: In patients completely worked up with endoscopic procedures (i.e. colonoscopy and upper endoscopy) in which an explanation for chronic abdominal pain is not apparent, 12% of patients had an abnormal enteroclysis finding which could have explained the chronic abdominal pain. Whether or not these findings actually contributed to the abdominal pain remains unclear.Enteroclysis is an relatively insensitive test for the evaluation of chronic abdominal pain but may be useful in a small percentage of patients after endoscopic evaluation if the source of chronic pain is not clear. In this study enteroclysis was most useful for defining adhesions 2/4(50%) which were not picked up by endoscopic diagnostic tests. 1/4(25%) of the positive enteroclysis findings in this study was due to Crohn's ileitis, and 1/4(25%) was due to a possible superior mesenteric artery syndrome.