Case Notes
History
91-day-old full term infant with history of distal small bowel obstruction with resection of the terminal ileum and ileostomy. The patient had an ileostomy reversal. The patient is having emesis and dilated loops of small bowel. We are asked to evaluate for an anastomotic stricture.Exam
FLUORO GI LOWER CONTRAST ENEMA. An 8 French feeding tube was inserted into the rectum and 200 cc of Cysto-Conray was injected with a Toomey syringe. The large open bowel was opacified from the rectum to the mid ascending colon. It was difficult to opacify the proximal colon. At this point, the patient evacuated the Cysto-Conray. We repeated the study to visualize the proximal colon. We injected 100 cc of Cysto-Conray in the right lateral decubitus position, but we were unable to opacify the proximal colon. The patient again evacuated the Cysto-Conray on the fluoroscopic table.