Barium examination of the small intestine

Abstract

The barium follow-through is still the most widely used technique for examining the small intestine with contrast medium despite evidence that it is not accurate for detecting and demonstrating diseases that cause morphological changes in the small intestine. Duodenal intubation techniques are now replacing the follow-through in many centres. Excellent visualisation is achieved when the barium is introduced directly through a tube into the small intestine. The single-contrast dilute barium infusion method described by Sellink is very satisfactory. Reports from centres using intubation methods indicate that they give much more accurate information than the follow-through. Diagnostic information may be obtained by injecting barium through intestinal tubes that are being used to decompress the distended intestine in patients with small intestinal obstruction. Per oral pneumocolon examination of the ileocaecal region and the complex reflux examination help to evaluate the ileum, particularly the terminal ileum.