Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination)
CPT4 code
Name of the Procedure:
Radiologic Small Intestine Follow-Through Study (Small Bowel Follow-Through, SBFT)
Summary
A radiologic small intestine follow-through study is an imaging procedure that uses X-rays to take multiple serial images of the small intestine. This is usually conducted after an upper gastrointestinal (GI) radiologic examination to provide a detailed view of the small intestine's structure and function.
Purpose
This procedure is used to diagnose abnormalities in the small intestine, such as blockages, strictures, inflammatory diseases (e.g., Crohn's disease), and other conditions. The goal is to generate detailed images that provide crucial information for accurate diagnosis and treatment planning.
Indications
- Unexplained abdominal pain
- Chronic diarrhea
- Bleeding from the gastrointestinal tract
- Suspected Crohn's disease or other inflammatory bowel diseases
- Suspicion of small bowel tumors or blockages
Preparation
- Patients may be instructed to fast for 8-12 hours before the procedure.
- Avoid smoking or chewing gum before the procedure as they might stimulate stomach activity.
- You might need to abstain from certain medications; consult with your healthcare provider.
- A preliminary consultation and possibly other diagnostic assessments, such as blood tests or an initial upper GI series, may be required.
Procedure Description
- The patient consumes a contrast material (barium sulfate), which coats the lining of the small intestine.
- Multiple serial X-ray images are then taken over a period to track the progress of the barium through the small intestine.
- The patient may be asked to move into various positions to ensure comprehensive imaging.
- Radiologic technologists and sometimes a radiologist will carry out the imaging process using specialized X-ray equipment.
Duration
The procedure typically takes between 2 to 6 hours, depending on how quickly the barium moves through the small intestine.
Setting
The procedure is performed in a hospital or outpatient radiology center equipped with the necessary imaging technology.
Personnel
- Radiologist (physician specializing in interpreting medical images)
- Radiologic technologists (perform the imaging)
- Nurses (may assist with patient preparation and monitoring)
Risks and Complications
- Exposure to a low level of radiation.
- Possibility of allergic reaction to the barium contrast.
- Potential for constipation or fecal impaction due to the barium.
- Minor risk of aspiration if the patient has difficulty swallowing.
Benefits
- Non-invasive method to obtain detailed images of the small intestine.
- Assists in accurate diagnosis which can lead to effective treatment.
- Can detect a variety of conditions that might be missed by other tests.
Recovery
- Patients can usually resume normal activities immediately following the procedure.
- Increased fluid intake is recommended to help pass the barium contrast from the body.
- Follow-up may include additional imaging or consultations based on the results.
Alternatives
- Capsule endoscopy: swallowing a small capsule with a camera to capture images.
- Enteroclysis: a more direct, though invasive, imaging of the small intestine using a contrast agent and fluoroscopy.
CT or MRI enterography: advanced imaging techniques providing detailed cross-sectional views.
Each alternative has its pros and cons regarding invasiveness, detail of images obtained, and patient comfort.
Patient Experience
- The patient may feel a bit bloated or full after consuming the barium contrast.
- There is generally little to no pain associated with the actual imaging process.
- Staff will provide instructions on how best to stay comfortable and may offer tips for any slight discomfort experienced post-procedure.