Radiographer performed single contrast small bowel enteroclysis

Abstract

Aim To analyse the technical success and reporting sensitivity of radiographer performed small bowel enteroclysis (SBE) undertaken by a specialist radiographer according to a standard technique [Nolan DJ, Cadman PJ. The small bowel enema made easy. Clinical Radiology 1987;38(3):295–301]. Methods Patients (1413) had 1646 SBE in 10 years from May 1992 to April 2002. The original request card and the separate radiographer and consultant radiologist reports were reviewed. Where the radiology reports were discordant or inconclusive, the clinical notes were also reviewed. Results Patients (1022) X-ray films were available. Nine hundred and forty-three (93.3%) SBEs had been successfully completed. Radiographer and consultant radiologist reporting had a 99.3% concordance. There was a 98.4% sensitivity for Crohn's disease (181 of 184 cases where Crohn's disease was the clinical final diagnosis). Overall reporting sensitivity was 93.7% although correct ‘probably normal and abnormal’ reporting bias suggests a sensitivity of 96.9%. Sixty of 943 (6.4%) reports were inconclusive. Of 1022 patients, 68 (6.6%) of small bowel intubations were not achieved, or else consent was withdrawn at the time of the procedure. Conclusion Specialist radiographers can perform small bowel enteroclysis with a reporting sensitivity equal to that of a consultant radiologist. Radiographers accustomed to providing an SBE service become skilled at passing fine bore feeding tubes into the small bowel and can provide this service also.