CT Enterography is a new method of evaluating the small bowel. Currently, the small bowel is the most difficult portion of the bowel to evaluate. No endoscope can reach the small bowel. Traditionally, enteroclysis has been performed, in which a tube is advanced through the nose into the small bowel, and a solution is infused to distend and opacify the small bowel. This test is poorly tolerated by most patients.
Small bowel series are barium studies which require drinking a solution of barium, and are the main method of evaluating the small bowel. Drawbacks include non-visualization of the remainder of the abdomen or of the wall of the small bowel.
CT Enterography combines elements of small bowel studies with CT scanning of the abdomen. Patients drink a solution similar to barium that provides distension of the bowel. It has proven quite successful in evaluating the small bowel for neoplastic or inflammatory conditions, including Crohn’s disease.
CT enterography requires no additional preparation and can be ordered just as a CT Scan of the abdomen with IV and oral contrast. “Volumen” oral contrast agent substitutes for traditional barium oral contrast material. Volumen achieves negative contrast, and highlights areas of enhancement following IV contrast administration, which is administered to evaluate for inflammation in the wall of the bowel. Volumen can be taken when you arrive at the imaging center, and does not need to be picked up prior to the exam. It does however require that you come 1 hour earlier for the exam to start drinking the Volumen.