Pattern Approach for Diseases of Mesenteric Small Bowel on Barium Studies
Radiology: Volume 249: Number 2—November 2008
Marc S. Levine, MD Stephen E. Rubesin, MD Igor Laufer, MD
Despite an array of sophisticated imaging techniques, the barium examination remains a valuable diagnostic test for evaluating structural abnormalities of the small bowel. Most patients can be examined with conventional small-bowel follow-through studies, in which periodic imaging of the entire small bowel is performed by using fluoroscopic guidance; however, some patients may benefit from en-teroclysis, in which contrast agents are instilled into the small bowel via a catheter placed in the proximal jejunum for optimal distention and better depiction of individual small-bowel loops. This review for residents discusses the major diseases involving the mesenteric small bowel and presents a pattern approach for the wide spectrum of abnormalities found on barium studies, including polypoid lesions, cavitated lesions, annular lesions, outpouchings, separation of loops, abnormal folds, nodules without ab¬normal folds, and dilated small bowel.