Air (CO2) double-contrast barium enteroclysis

Dean D.T. Maglinte, Marc D. Kohli, Stefania Romano, John C. Lappas

Research output: Contribution to journalReview article

18 Scopus citations


In the 1980s and 1990s in North America and Europe, air (CO2) double-contrast barium enteroclysis took a back seat to biphasic methylcellulose double-contrast enteroclysis in the investigation of small-bowel diseases. The widespread application of capsule endoscopy in the 21st century has identified a number of limitations of radiologic examinations in the investigation of mucosal diseases of the small intestine. Evidence-based studies comparing barium, computed tomographic (CT), and magnetic resonance (MR) enteroclysis have shown that in spite of improvements in small-bowel examination methods using CT and MR, barium examinations remain superior in the depiction of mucosal abnormalities, particularly the apthoid lesions of early Crohn disease. Barium small-bowel examinations have been recommended in the patient with a negative CT or MR enteroclysis study where the pretest probability of Crohn disease is high. A recent prospective comparison of methylcellulose double-contrast barium enteroclysis to capsule endoscopy with review of the literature has shown that air enteroclysis depicts mucosal details better than does methylcellulose double-contrast enteroclysis because of the "washout" effect of methylcellulose on superficial mucosal features. Recent articles have shown that air enteroclysis compares favorably with wireless capsule endoscopy and double-balloon endoscopy in the diagnosis of mucosal abnormalities of the small bowel. This article describes the authors' technique of performing air doublecontrast enteroclysis, its clinical indications, and its pitfalls.

Original languageEnglish (US)
Pages (from-to)633-641
Number of pages9
Issue number3
StatePublished - Sep 1 2009

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Maglinte, D. D. T., Kohli, M. D., Romano, S., & Lappas, J. C. (2009). Air (CO2) double-contrast barium enteroclysis. Radiology, 252(3), 633-641.