Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) study, including glucagon, when administered
CPT4 code
Name of the Procedure:
Radiologic Examination, Small Intestine with Multiple Serial Images and Scout Abdominal Radiograph(s); Double-Contrast (e.g., High-Density Barium and Air via Enteroclysis Tube) Study, Including Glucagon When Administered.
Summary
This procedure uses X-rays to take detailed images of the small intestine. It involves introducing a high-density barium and air into the intestine through a special tube and taking multiple images to visualize the intestine's condition. Sometimes, the medication glucagon is administered to relax the intestines.
Purpose
The primary goal of this examination is to diagnose and evaluate abnormalities in the small intestine. It helps identify issues such as blockages, tumors, inflammation, and other structural problems.
Indications
- Unexplained abdominal pain
- Suspected small intestine tumors
- Inflammatory bowel disease
- Unexplained gastrointestinal bleeding
- Chronic diarrhea or malabsorption syndromes
Preparation
- Patients are typically required to fast for 8–12 hours before the procedure.
- Intake of clear liquids might be allowed until a few hours before the exam.
- Abstaining from certain medications as advised by the healthcare provider.
- Sometimes, a bowel cleansing agent is administered to ensure the intestines are empty.
Procedure Description
- The patient lies on an X-ray table.
- A thin, flexible tube (enteroclysis tube) is gently inserted through the nose or mouth into the small intestine.
- High-density barium is introduced via the tube to coat the lining of the small intestine.
- Air is then carefully introduced to provide a double-contrast effect.
- Multiple X-ray images are taken at various intervals.
- Glucagon may be administered to slow down intestinal movement and improve image quality.
Tools and technology used include the enteroclysis tube, barium, air infusion equipment, and X-ray machines.
Duration
The entire procedure typically takes about 1 to 2 hours.
Setting
This procedure is usually performed in a hospital radiology department or an outpatient imaging center.
Personnel
- Radiologist (specialized doctor who interprets the images)
- Radiologic technologist (who assists with the procedure)
- Nurses for patient care and support
- An anesthesiologist, if sedation is necessary
Risks and Complications
- Mild discomfort or bloating due to the air
- Nausea or vomiting
- Rare risks: bowel perforation or allergic reaction to barium or glucagon.
- Management of complications typically involves additional medical treatments or interventions.
Benefits
- Accurate diagnosis of small intestine abnormalities
- Non-invasive with detailed, high-quality images
- Results can guide appropriate treatment plans
Recovery
- Patients might experience mild abdominal cramping or bloating post-procedure, which usually resolves within a few hours.
- Normal diet and activities can often be resumed shortly after the procedure.
- Follow-up appointments may be scheduled based on the results.
Alternatives
- Capsule endoscopy: Swallowing a small camera to take images of the intestine.
- CT enterography or MRI enterography: Advanced imaging techniques using CT or MRI technology.
- Traditional barium follow-through: An older but simpler imaging technique.
Pros and cons of alternatives vary in terms of detail, comfort, and the specific conditions they best assess.
Patient Experience
- During the procedure, patients might feel discomfort from the insertion of the tube and the introduction of air.
- Post-procedure, some bloating or mild cramping might occur.
- Pain management and comfort measures like guided breathing techniques and relaxation methods are often employed.