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Peroral pneumoileum in patients with ileostomy.

Peroral pneumoileum extends the peroral pneumocolon technique to patients with ileostomy to improve visualization of the ileum when the small-bowel examination is limited by poor distension, overlapping loops or adhesions. The author describes the technique in detail and presents the findings for 25 patients (10 men and 15 women) examined for suspected ileostomy dysfunction, recurrent Crohn's disease or ileal obstruction remote from the stoma. In only one patient was retrograde single-contrast enema required in addition to the antegrade small-bowel series with peroral pneumoileum. In seven of the patients, the demonstration of abnormalities with this technique influenced subsequent management. Peroral pneumoileum overcomes several of the limitations of antegrade and retrograde examinations and enables complete jejunoileal assessment with a single radiologic procedure.