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Computed Tomography (CT) - Enterography

Article
Digestive Health
Health & Wellness
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Contributed byMaulik P. Purohit MD MPHNov 30, 2018

Background Information:

What are the other Names for the Procedure?

  • CAT - Enterography
  • CT - Enterography
  • X-ray Computed Tomography - Enterography 

What is Computed Tomography (CT) scan of the Small Intestine radiology procedure? (General Explanation)

  • CT (Computed Tomography) scanning, also referred to as a CAT scan, is a noninvasive test used to diagnose and treat medical conditions, by combining a special X-ray machine with computers, to produce images of the body insides
  • CT scanning provides more details of soft tissues, blood vessels, and internal organs, than a regular X-ray exam
  • A Computed Tomography - Enterography is used to produce images of the small intestine

What part of the Body does the Procedure involve?

A CT Enterography scan involves the small intestine.

Why is the Computed Tomography (CT) scan of the Small Intestine radiology procedure Performed?

A CT Enterography scan is performed for the following reasons:

  • To diagnose and monitor treatment of Crohn’s disease
  • To identify tumors, bowel obstruction, inflammation, bleeding sources, or any abscess

What is the Equipment used? (Description of Equipment)

The CT equipment for a CT Enterography consists of:

  • A CT scanner that appears like a big box with a hole inside
  • The examination table on which the patient lies down; the table slides into the hole during the procedure
  • X-ray tube and electronic X-ray detectors that rotates around the patient
  • Images are taken from a computer

A transducer (part of the scanner) is used to send high frequency sound waves in the body and the computer creates the images, based on the echoes of that sound returning from the patient’s body.

What are the Recent Advances in the Procedure?

There have been no recent advances to replace the CT scan procedure. 

What is the Cost of performing the Computed Tomography (CT) scan of the Small Intestine radiology procedure?

The cost of a CT Enterography procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary. 

When do you need a Second Opinion, prior to the Procedure?

  • It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding CT Enterography scan procedure and what needs to be done
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
  • Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently 

What are some Helpful Resources?

http://www.radiologyinfo.org/en/info.cfm?pg=CTenterography (accessed on June 7, 2014)

Prior to Computed Tomography (CT) scan of the Small Intestine radiology procedure:

How does the Computed Tomography (CT) scan of the Small Intestine radiology procedure work?

  • A CT scan is very similar to taking an X-ray. In an X-ray, radiation passes through the body and an image is recorded on photographic film. The bones appear white, air appears black, and soft tissues appear as gray patches
  • In the CT scan, electronic X-ray detectors and X-ray beams rotate (around the patient) and measure the amount of radiation absorbed
  • The X-ray beam in a CT scan follows a spiral path, as the examination table is moving through the scanner
  • A two-dimensional, cross sectional image of the body is created by a computer program, by utilizing all the data generated by the scanner. The CT scan produces a very detailed multidimensional view of the body’s interior regions
  • The CT Enterography scan produces images of the abdomen and intestinal region, in a way as can be compared to looking at a loaf of bread, by cutting the loaf into thin slices

How is the Computed Tomography (CT) scan of the Small Intestine radiology procedure Performed?

  • Before the procedure, patients are asked to drink about 1 liter of a liquid containing a contrast material, over a period of an hour, to fill and expand the small intestine, so that abnormalities may be seen easily and clearly
  • For a CT Enterography, the patient is asked to lay flat on their back, side, or stomach, during the examination
  • As any motion may affect the quality of examination, patients are asked to stay still on the table
  • Children may be given a sedation, to keep them still
  • The CT table moves into the scanner and the patients are asked to hold their breath for about 15 seconds

Where is the Procedure Performed?

A CT Enterography scan is performed as an outpatient procedure, at a hospital.

Who Performs the Procedure?

A CT Enterography scan is usually performed by a radiology technologist.

How long will the Procedure take?

The CT Enterography scan will take about 30-60 minutes.

Who interprets the Result?

  • A radiologist interprets the results of the CT Enterography scan
  • Follow-up examination may be needed, if anything suspicious is detected during the exam, or to monitor the abnormality over time
  • A follow-up is also availed in order to check effectiveness of the treatment administered

What Preparations are needed, prior to the Procedure?

The following preparations may be needed prior to a Computed Tomography Enterography scan:

  • The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient, including information related to the medications that are being currently taken
  • Do inform the medical professional if you have a history of any medical conditions, such as a heart disease, asthma, diabetes, or kidney disease
  • Do inform the medical professional about any allergies, especially related to barium or iodinated contrast material, which may be used in the procedure
  • It is advisable to wear comfortable and loose clothes. Avoid wearing any metal objects or jewelry, as it may interfere with the X-ray
  • It is highly recommended to inform your healthcare professional, if you are pregnant or breastfeeding
  • The patient must avoid eating or drinking at least 8 hours prior to the procedure, depending on when the procedure is arranged

What is the Consent Process before the Procedure?

A physician will request your consent for a Computed Tomography - Enterography scan procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied with the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of the CT Enterography procedure:

  • The procedure may eliminate the need for a video capsule endoscopy (VCE)
  • It is a fast, easy, and painless noninvasive procedure
  • The procedure is very accurate and gives more detailed information of blood vessels, lungs, bones, and tissues, than an X-ray or an MRI scan
  • The method can be used in emergency situations
  • Unlike MRI, it is less movement-sensitive (the patients are generally asked to remain very still, while the test is under progress, for both a CT scan and an MRI scan as well)
  • It may eliminate the need for surgeries

Following are the risks of the CT Enterography procedure:

  • Over-exposure to radiation in a CT scan procedure may cause cancer. But, generally the chances of developing cancer is very remote
  • There is a rare chance of developing an allergic reaction, due to the contrast material containing iodine used in the CT scan
  • CT scanning is recommended for children, only if it is absolutely necessary, as children are very sensitive to radiation

What are the Limitations of the Computed Tomography (CT) scan of the Small Intestine radiology procedure?

  • In some cases, obese or large patients may have a difficulty in bodily fitting into the CT scanner
  • Some early inflammation, small tumors, and bowel obstruction, may not be visualized using CT Enterography

What are some Questions for your Physician?

Some of the basic questions that you might ask your healthcare provider or physician are as follows:

  • What is the Computed Tomography Enterography scan procedure?
  • Why is this procedure necessary? How will it help?
  • How soon should I get it done? Is it an emergency?
  • Who are the medical personnel involved in this procedure?
  • Where is the procedure performed?
  • What are the risks while performing the procedure?
  • What are the complications that might take place, during recovery?
  • What are the possible side effects from the procedure? How can I minimize these side effects?
  • How long will it take to recover? When can I resume normal work?
  • How many such procedures have you (the physician) performed?
  • Are there any lifestyle restrictions or modifications required, after the procedure is performed?
  • Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
  • Is there any medication that needs to be taken for life, after the procedure?
  • What are the costs involved?

During the Computed Tomography (CT) scan of the Small Intestine radiology procedure:

What is to be expected during the Computed Tomography (CT) scan of the Small Intestine radiology procedure?

  • There is no pain involved with a CT Enterography procedure
  • There might be some noise of the device, as involved with any regular machine function
  • The individual may experience some anxiety, due to the noise of the machine, or from staying still for a long time, but no scan associated pain may be felt

What kind of Anesthesia is given, during the Procedure?

No anesthesia is administered during a CT Enterography procedure. 

How much Blood will you lose, during the Procedure?

There is no blood loss during a CT Enterography procedure.

What are the possible Risks and Complications during the Computed Tomography (CT) scan of the Small Intestine radiology procedure?

  • Over-exposure to radiation in a CT Enterography scan procedure may cause cancer; however, such a risk is very low
  • The CT scan procedure is not recommended for pregnant women
  • Mothers are advised to breastfeed their children, only 24 hours after the contrast material for CT scanning is injected
  • There is a rare chance of developing an allergic reaction, due to the contrast material containing iodine used in the CT scan
  • CT scanning is recommended for children, only if absolutely necessary, as children are very radiation-sensitive

What Post-Operative Care is needed at the Healthcare Facility after the Computed Tomography (CT) scan of the Small Intestine radiology procedure?

There is no post-operative care necessary after a CT Enterography scan, at the healthcare facility.

After the Computed Tomography (CT) scan of the Small Intestine radiology procedure:

What is to be expected after the Computed Tomography (CT) scan of the Small Intestine radiology procedure?

Generally, no complications or side effects are observed after the CT Enterography procedure. 

When do you need to call your Physician?

If the patient is experiencing an allergic reaction from the contrast reaction; then, do contact the physician.

What Post-Operative Care is needed at Home after the Computed Tomography (Ct) scan of the Small Intestine radiology procedure?

There is no post-operative care necessary after the CT - Enterography scan, at home.

How long does it normally take to fully recover, from the Procedure?

The patient needs no recovery time after the CT Enterography scan.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

No tissue is extracted from the patient during a CT Enterography procedure.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the Computed Tomography (CT ) scan of the Small Intestine radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers. 

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

  • The hospital, where the procedure is performed
  • Radiologist or neurologist, performing the procedure
  • Healthcare providers, physicians, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the CT Enterography scan procedure is performed.

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Maulik P. Purohit MD MPH picture
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Maulik P. Purohit MD MPH

Assistant Medical Director, Medical Editorial Board, DoveMed Team

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