Running head: CT ENTEROGRAPHY 1

CT Enterography
Anthony Mitchell
Maine College of Health Professions
Jennifer Dixon
February 20, 2021
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CT Enterography

CT Enterography is commonly used to identify problems within the small bowel, such as

inflammation, bleeding, obstructions, and Crohn's disease. A CT enterography is typically

ordered as an abdomen/pelvis as detailed images of the small intestine and structures within the

abdomen and pelvis can be observed for pathologies. CT enterography can better visualize the

entire thickness of the bowel wall compared to other small intestine imaging procedures. It is

increasingly replacing fluoroscopy in imaging the small bowel. Additionally, CT enterography is

less invasive and can reach different regions of the abdomen than endoscopy.

A common use of CT enterography is to assess and monitor complications of Crohn's

disease. Other reasons an enterography is typically ordered include small bowel inflammation,

bleeding within the small bowel, small bowel tumors, abscesses and fistulas, bowel obstruction,

celiac disease, postoperative adhesions, radiation enteritis, scleroderma, small bowel

malignancies, and polyposis syndromes.

Both oral and intravenous contrast is used when performing CT enterography. The

patient must arrive at least one hour before the exam for the oral contrast to be administered.

Typical protocols require the oral contrast (in the small bowel case, usually a dilute barium

sulfate or gastrografin if barium is contraindicated) to be consumed at intervals totaling 1 hour.

The oral contrast is used to highlight specific organs and better show the presence of disease or

injury. Oral contrast follows the digestive system versus venous contrast following the venous

pathways.
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Upon arriving, the patient:

 Is asked if they have had anything to eat or drink in the last 4 hours (patients

should have been previously briefed not to).

 Questioned about any medical conditions and any previous reactions to contrast

 The patient is asked about medications ( in the case of metformin, the patient is

informed when to begin retaking it, usually 48 hours following the exam)

 Asked if they consent to the exam

 If an outpatient, an intravenous IV is placed. ED patients have the IV placed by

their nurse.

 Creatinine levels are checked and taken if necessary. (typically required on all

patient plus 60 years of age)

 The patient is given 1 to 1.5 liters of oral contrast and instructed to drink the

contrast in intervals typically up to one hour.

Once the hour has passed, and the patient has consumed the oral contrast, the patient is

ready for the exam. Ensuring there is no metal or other artifacts in the area to be examined, the

patient is customarily placed supine with feet toward the gantry. The IV contrast is hooked up,

and the patient is informed of how the exam works and what are normal and abnormal sensations

during the IV contrast being administered. A saline flush is passed through the IV to ensure

proper flow. The patient is then positioned (centered correctly) within the gantry to begin the

test. A scout image is taken. The technologist ensures the proper flow rate for the IV and, as the

test is performed, informs the patient when the contrast begins and what sensations they may

feel. Once the imaging is completed, the patient is informed when to expect the results and

reminded to drink plenty of water to help flush the contrast from their system.
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