Enterografia peroral por tomografia computorizada: avaliação da patologia do intestino delgado por tomografia computorizada multicorte com contraste oral de goma de alfarroba-sorbitol

M. J. Barata¹, R. Lourenço¹, A. S. Capacho², J. Fonseca³, C. Cyrne¹

 

Resumo

Introdução: O estudo do intestino delgado tem evoluído extraordinariamente, mas ainda não está definido um método referencial. Descreve-se a utilização em Tomografia Computorizada de um contraste oral usado em Ressonância Magnética.

Objectivos: Avaliação da Enterografia Peroral por Tomografia Computorizada com goma de alfarroba-sorbitol no estudo do intestino delgado.

Material e Métodos: Doze doentes realizaram Enterografia Peroral por Tomografia Computorizada: 7 por suspeita de doença de Crohn, 2 para estudo de doença de Crohn conhecida e 3 por hemorragia digestiva e/ou anemia. Efectuouse o estudo num aparelho multicorte, após admnistração endovenosa de contraste iodado, com distensão prévia do intestino com solução oral hiperosmolar (goma de alfarroba-sorbitol). Avaliou-se: tolerância, distensibilidade intestinal e acuidade diagnóstica deste método.

Resultados: O exame foi bem tolerado em todos os doentes. Confirmou o diagnóstico de doença de Crohn em 4, avaliou complicações desta doença em 2, diagnosticou tumores no delgado em 1 e no cólon em 1. A distensibilidade intestinal foi boa ou óptima em todos. Registaram-se apenas complicações minor do contraste oral: desconforto abdominal em 1 e diarreia em 3.

Conclusões: A Enterografia Peroral por Tomografia Computorizada com goma de alfarroba-sorbitol revelou-se uma técnica simples, bem tolerada e útil no estudo do intestino delgado.

 

Summary

Introduction: Despite advances in the study of the small bowel, a gold standard method has not yet been defined. Here we report our experience with Computed Tomography with an oral contrast material used for Magnetic Resonance Imaging.

Purpose: To assess Computed Tomographic Enterography with locust bean gum-sorbitol in evaluating the small bowel.

Materials and Methods: Twelve patients underwent Computed Tomographic Enterography: 7 suspected of having Crohn’s disease, 2 for assessment of known Crohn’s disease and 3 with gastrointestinal bleeding/anemia. After intravenous administration of iodinated contrast material and prior small bowel distension using an osmotic oral contrast material (locust bean gum-sorbitol), images were obtained with a multi-detector row helical computed tomography scanner. We assessed: i) patients tolerance, ii) small bowel distension and iii) accuracy of this method.

Results: Computed Tomographic Enterography was well tolerated in all patients. It diagnosed Crohn’s disease in 4 patients, helped assess complications of the disease in 2 and detected tumours in the small bowel in 1 and in the colon in 1. The degree of small bowel distension was good or optimal in all cases. The patients reported minor side effects associated with the oral contrast material: abdominal pain in 1 and diarrhea in 3.

Conclusion: Computed Tomographic Enterography with locust bean gum-sorbitol is a simple, non-invasive and effective method of evaluating the small bowel.

 

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(1) Serviço de Radiologia.

(2) Serviço de Farmácia.

(3) Serviço de Gastrenterologia.

Hospital Garcia de Orta, Almada, Portugal.

 

Recebido para publicação: 03/11/2005

Aceite para publicação: 08/04/2006