THE COMPLETE reflux small-bowel examination offers distinct advantages in precise location and identification of small-bowel lesions. This method is useful especially to diagnose tumors of the small intestine. It can aid in the differential diagnosis of inflammatory lesions, strictures, adhesive bands, gallstone obstruction, and tumors. We have previously reported metastatic tumors, intussuscepted Meckel diverticulum, inflammatory fibroid polyps, and blood clots found by this method, which had not been detected by antegrade studies.1-3 However, all of these small intraluminal tumors have similar appearances, may be accompanied by hemorrhage, and intermittent or partial obstruction. They appear as round, relatively smooth, or slightly nodular, thumb-like indentations, or filling defects in the small intestine (Figure). The reflux small-bowel examination was also useful in one patient with metastatic carcinoma, to prove that her bowel obstruction was not caused by tumor, but that it was the result of adhesions. As a result, a simple operation
Miller RE. Retrograde Small-Bowel Examination. JAMA. 1974;229(11):1500–1501. doi:10.1001/jama.1974.03230490080040
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