Rofo 2017; 189(09): 855-863
DOI: 10.1055/s-0043-111598
Abdomen
© Georg Thieme Verlag KG Stuttgart · New York

Clinical Value of Contrast Enema Prior to Ileostomy Closure

Article in several languages: English | deutsch
Andrea Goetz
1   University Hospital Regensburg, Department of Radiology, Regensburg, Germany
,
Natascha Platz Batista da Silva
1   University Hospital Regensburg, Department of Radiology, Regensburg, Germany
,
Christian Moser
2   Clinic Bogenhausen, Munich, Department of General, Visceral, Endocrine and Minimally-Invasice Surgery, Munich, Germany
,
Ayman Agha
2   Clinic Bogenhausen, Munich, Department of General, Visceral, Endocrine and Minimally-Invasice Surgery, Munich, Germany
,
Lena-Marie Dendl
1   University Hospital Regensburg, Department of Radiology, Regensburg, Germany
,
Christian Stroszczynski
1   University Hospital Regensburg, Department of Radiology, Regensburg, Germany
,
Andreas G. Schreyer
1   University Hospital Regensburg, Department of Radiology, Regensburg, Germany
› Author Affiliations
Further Information

Publication History

27 December 2016

24 April 2017

Publication Date:
23 August 2017 (online)

Zoom Image

Abstract

Purpose To determine the value of routine contrast enema of loop ileostomy before elective ileostomy closure regarding the influence on the clinical decision-making.

Materials and Methods Retrospective analysis of contrast enemas at a tertiary care center between 2005 und 2011. Patients were divided into two groups: Group I with ileostomy reversal, group II without ileostomy closure. Patient-related parameters (underlying disease, operation method) and parameters based on the findings (stenosis, leakage of anastomosis, incontinence) were evaluated.

Results Analyzing a total of 252 patients in 89 % (group I, n = 225) ileostomy closure was performed. In 15 % the radiologic report was the only diagnostic modality needed for therapy decision; in 36 % the contrast enema and one or more other diagnostic methods were decisive. In 36 % the radiological report of the contrast imaging was not relevant for decision at all. In 11 % (group II, n = 27) no ileostomy closure was performed. In this group in 11 % the radiological report of the contrast enema was the only decision factor for not performing the ileostomy reversal. In 26 % one or more examination was necessary. In 26 % the result of the contrast examination was not relevant.

Conclusion The radiologic contrast imaging of loop ileostomy solely plays a minor role in complex surgical decision-making before planned reversal, but is important as first imaging method in detecting complications and often leads to additional examinations.

Key points

  • Contrast enema of loop ileostomy before planned ileostomy closure is a frequently performed examination.

  • There exist no general guidelines that give further recommendations on decision-making planning ileostomy closure.

  • The radiologic contrast imaging of loop ileostomy solely plays a minor role in decision-making before planned reversal, but is important as first imaging method.

Citation Format

  • Goetz A, da Silva NP, Moser C et al. Clinical Value of Contrast Enema Prior to Ileostomy Closure. Fortschr Röntgenstr 2017; 189: 855 – 863