Role of computed tomographic enterography for evaluation of small bowel diseases: A cross-sectional study

Abstract

Background: Computed tomographic enterography (CTE) is a newer non-invasive modality having distinct advantages over conventional CT and capsule endoscopy. Objectives: This technique allows faster evaluation of small bowel diseases in the endoscopically inaccessible segments. Being an operator-independent procedure, CTE is widely available and allows a better depiction of extra enteric complications. The aim is to evaluate CTE features of various small bowel diseases and the role of 2% mannitol for adequate small bowel distension. Materials and methods: A cross-sectional study comprising 105 patients had presented with small bowel diseases. Patients in the age group of 10 to 85 years with complaints of fever, abdominal pain, nausea, vomiting, altered bowel habits, loss of appetite and loss of weight were included in this study. CTE images were analyzed to compare the diagnosis with the available histopathological and ultrasonography results. Results: Among the study population, the majority had presented CTE features such as symmetrical wall thickening (53.3%), peri-bowel inflammatory changes (61%), mucosal hyperenhancement (39%), and mural stratification, i.e., target sign (33.3%). The majority of diagnoses of CTE were ileocecal tuberculosis (11.5%), small bowel inflammation (7.6%), and Crohn’s disease (6.7%). Other conditions such as small bowel neoplastic masses, diverticula, ischemic bowel disease, bowel strictures, intussusception, and ulcerative colitis. Conclusion: CTE has the vital role of first-line modality in the work-up of suspected small intestinal diseases and helps evaluate disease activity before endoscopy, particularly in inaccessible segments. It allows a better depiction of extra enteric complications of the bowel.