A prospective randomized comparison between small bowel enteroclysis and small bowel follow-through in Crohn's disease.

BACKGROUND & AIMS: Small bowel enteroclysis (SBE) has been suggested to be superior to the small bowel follow-through (SBFT) for diagnosing the presence and extent of Crohn's disease. The aim was to perform a prospective randomized study at a single university medical center comparing SBE with SBFT in patients with Crohn's disease.

METHODS

Consecutive patients with known Crohn's disease were randomized to receive either SBE or SBFT as the initial study and had the alternate study performed within 2 weeks.

RESULTS

Twenty-six patients were enrolled. The mean time between studies was 8.7 +/- 0.8 days. Both studies were normal in 7 cases. The SBE was negative in 3 cases with positive findings of Crohn's disease by SBFT. One of these cases was a false-positive SBFT. The SBE and SBFT were both diagnostic of Crohn's disease in 15 cases; in 6 cases there was uniform agreement regarding disease pattern. The SBFT more accurately reported mucosal detail (n = 3) and a greater number of fistulas (n = 2). The SBE missed duodenal disease (n = 4).

CONCLUSIONS

In known Crohn's disease, the SBFT is the procedure of choice. It is safer, preferred by patients, and will not miss gastroduodenal disease, and when the result is normal, there is no need to perform SBE.