The value of the small bowel enema in children.

Thirty-one small bowel enema (SBE) examinations performed in children over a four-year period have been reviewed. Thirteen of the patients had had a recent conventional barium follow-through (CBFT) examination resulting in a diagnostic dilemma. In 4 of these 13, mass lesions had been suspected and the SBE confirmed a diagnosis of Crohn's disease and thus laparotomy was avoided. In four others, where the terminal ileum had been poorly seen on CBFT, the SBE clearly indicated Crohn's disease. In the remaining five, although the CBFT examination had suggested an abnormality, the SBE results were obviously normal. Of the other 18 patients, all without a recent CBFT study, the SBE provided useful information in 17 and was unhelpful in 1 patient. Thus, the small-bowel enema is a valuable investigation in pediatric patients particularly if adhesions or small-bowel tumors are suspected, or when a conventional study fails to demonstrate the terminal ileum adequately or is not diagnostic.