Small Bowel Imaging

Evaluation of the small bowel can be challenging given the amount of bowel present and variability in its appearance based on mobility, contrast use, and distension. Computed tomography (CT) plays a central role, although a comfort with small bowel evaluation on radiograph/fluoroscopy, ultrasound, and magnetic resonance imaging is also important. General categories of pathological processes include enteritis, small bowel masses, obstruction, mesenteric ischemia, and trauma. Given the amount of overlap between the imaging features of different types of enteritis and bowel masses, clinical correlation with or without tissue sampling is often required for accurate diagnosis. Closed-loop small bowel obstruction, mesenteric ischemia, and suspected traumatic injury to the bowel or mesentery are critical diagnoses to identify and report accurately and promptly.