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Published online before print September 23, 2008, 10.1148/radiol.2491071336
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(Radiology 2008;249:445-460.)
© RSNA, 2008

Reviews for Residents

Pattern Approach for Diseases of Mesenteric Small Bowel on Barium Studies1

Marc S. Levine, MD, Stephen E. Rubesin, MD, and Igor Laufer, MD

1 From the Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104. Received July 28, 2007; revision requested September 26; revision received September 27; accepted December 11; final version accepted December 13; final review by M.S.L. May 9, 2008. Address correspondence to M.S.L. (e-mail: marc.levine{at}uphs.upenn.edu).

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 enteroclysis, 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 abnormal folds, and dilated small bowel.

© RSNA, 2008






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