Search

The study of the small bowel has always represented a challenge to investigators. Until recently, methods with several limitations, such as small bowel follow through and conventional enteroclysis were the only available imaging methods to explore this bowel segment(1,2). In the last years, with technological advances, several methods have been developed for imaging the small bowel. Nowadays, capsule endoscopy(3) and double-balloon enteroscopy may be mentioned, but are expensive methods and are not widely available in Brazil. Computed tomography (CT) or magnetic resonance (MRI) enterography and enteroclysis combine the advantages of conventional radiological methods with those of sectional methods, i.e., luminal distention associated with multiplanar visualization of the whole abdominal and pelvic cavity without images overlapping. With such methods, the whole thickness of the intestinal wall can be visualized, including the mucosa, submucosa, muscular and serous layers, as well as the perienteric fat, vasa recta, lymph nodes and the contrast enhancement pattern, allowing the identification of parietal thickening, inflammatory signs, fistulas, collections, besides foci of bleeding and tumors, among others(2,5-7). Luminal distention constitutes an essential step in the interpretation of small bowel images, since collapsed loops with adhesions may either hide or simulate diseased segments(2,5–7). In the present issue of Radiologia Brasileira, D’Ippolito et al.(8) evaluate the performance of different neutral oral contrast media, comparing capability of bowel distention, intestinal wall definition, patient’s acceptance and side effects. The authors describe the