Small-bowel radiography

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Abstract
Radiologic techniques to examine the small bowel have shown little progress in recent decades. The advent of more versatile endoscopes and skilled endoscopists have brought to light the limitations of the upper gastrointestinal series and the barium enema, but this does not yet apply to the small bowel. Although small bowel endoscopes exist, they are few and have limited clinical application. Even with the advances made by ultrasound, computerized tomography, and magnetic resonance imaging, clinical evaluation of the small bowel still depends upon barium contrast examination. In many medical centers in other countries, the followthrough or progress meal has been largely replaced by enteroclysis. Unfortunately, this is not the situation in the United States. Enteroclysis or the small bowel enema is an underutilized method of examining the small bowel in this country (1, 2). This might be, in part, related to the clinician's lack of understanding of the inherent limitations of the small bowel follow-through (3). The small intestine is the most difficult area of the gastrointestinal tract to evaluate radiologically. When a small bowel examination is requested, usually in conjunction with an upper gastrointestinal series, the radiologist performs the upper gastrointestinal examination and the technologist then takes a series of overhead radiographs after ingestion of variable amounts of additional barium. Radiographs are obtained every 15-20 min for the first

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