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Radiologic Examination of the Small Intestine by Duodenal Intubation

Although the roentgen examination of the small intestine has been a common procedure for the past 70 years, the results unfortunately still give little cause for satisfaction. While knowledge of the diseases of the small bowel has increased considerably the radiologic examination has hardly changed. As a result of diverging views, a number of techniques have been developed; these differ to such an extent that the average transit time may vary from 1 to 6 hours. This is perhaps not surprising in view of the fact that the time is dependent upon factors such as the amount, caloric and osmotic values as well as the temperature and method of administration of the contrast medium. In addition, the number of media on the market continues to grow although even today none approaches the ideal. Standardization of the method of examination and the contrast medium has been suggested. BRAECKMAN (1947) analysed the influence of particle size and the addition of hydrophilic colloids on the rate of sedimentation of a barium sulphate suspension and plotted the results against time (Fig. 1). ZIMMER (1948) was one of the first to investigate flocculation in vitro by adding substances from the digestive tract, such as mucin, fatty acids and gastric juice, that enhance the phenomenon. The percentage of flocculation was also recorded against time (Fig. 2). The curves of BRAECKMAN and ZIMMER proved to be practically identical and in-