The Diagnosis of Intestinal obstruction by Small Bowel Enterography through Nasointestinal Decompression Tube

To investigate the clinical value of small bowel enema through nasointestinal decompression tube in diagnosis of small-bowel obstruction, Thirty-five patients with small-bowel obstruction, who had no sign of emergency operation, were catheterized with 300 cm tube to superior segment of jejunum under X-ray observation. The tube was put to approach to the lesion as far as we can due to progressive decompressing, so that selective enhanced contrast could be performed. 20-100 mL 76% meglucamine diatrizoate was infused through the tube under X-ray fluoroscopy, then 50-200 mL air was infused for double contrast. Local dynamic mutiple position observation was conducted and spot films were taken. The tube was pumpbacked to superior segment of jejunum if necessary. The results showed that the tube was successfully inserted in all cases. After the decompression of intestine, remission of obstruction were found in 20 cases, palliation in another 15 cases with 10 cases of surgical treatment. The local images of 35 cases by small bowel enema through nasointestinal decompression tube were clear, no overlapping, with prominent key focus. No significant abnormal Xray sign was observed in 6 cases, adhesive intestinal obstruction in other 15 cases, and cancer of small intestine in another 4 cases (metastatic tumor in 3 cases, carcinoma of small intestine in 1), Crohn’s disease 3, radial enteritis 3(one of the patients had be misdiagnosed as having metastatic cancer), intussusception 2, polyposis 1, carcinoma of ascending colon 1. It is concluded that the transnasal decompressive catheterization was effective in both decompressive treatment and selective enhanced contrast of small intestine, which was available in ascertain obstructive site, grade, and cause providing reliable information for surgical operation.