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. 2014 Jul-Aug;28(7):391-5.
doi: 10.1155/2014/501043.

Small bowel obstruction following computed tomography and magnetic resonance enterography using psyllium seed husk as an oral contrast agent

Yingming Amy Chen, Patrick Cervini, Anish Kirpalani, Paraskevi A Vlachou, Samir C Grover, Errol Colak

Small bowel obstruction following computed tomography and magnetic resonance enterography using psyllium seed husk as an oral contrast agent

Yingming Amy Chen et al. Can J Gastroenterol Hepatol. 2014 Jul-Aug.

Abstract
in English, French

The authors report a case series describing four patients who developed small bowel obstruction following the use of psyllium seed husk as an oral contrast agent for computed tomography or magnetic resonance enterography. Radiologists who oversee computed tomography and magnetic resonance enterography should be aware of this potential complication when using psyllium seed husk and other bulking agents, particularly when imaging patients with known or suspected small bowel strictures or active inflammation.

Les auteurs rendent compte d’une série de cas de quatre patients qui ont présenté une obstruction du grêle après avoir consommé l’enveloppe de psyllium comme agent oral de contraste en vue d’une tomodensitométrie ou d’une entérographie par résonance magnétique. Les radiologues qui supervisent les tomodensitométries et les entérographies par résonance magnétique devraient connaître cette complication potentielle lorsqu’ils utilisent l’enveloppe de psyllium et les autres agents gonflants, notamment lorsque les patients qui se soumettent à l’imagerie présentent un rétrécissement connu ou présumé ou une inflammation active du grêle.

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Figures

Figure 1)
Figure 1)
A Coronal computed tomography enterography image demonstrating active inflammation of the terminal ileum (arrow). The upstream small bowel is filled with oral contrast. B Upright abdominal radiograph performed 9 h later demonstrating dilated small bowel with air-fluid levels consist with a small bowel obstruction
Figure 2)
Figure 2)
A Coronal image from a normal computed tomography enterogram. B Supine abdominal radiograph performed the subsequent day demonstrating multiple distended loops of small bowel
Figure 3)
Figure 3)
A and B Axial computed tomography enterography images demonstrating a right lower quadrant parastomal hernia (arrowhead) with active inflammation of the immediately upstream small bowel (thin arrows). C and D Computed tomography scan performed 10 h later demonstrates diffuse small bowel dilation and fecalization of small bowel content (thick arrows) to the level of a transition point in the parastomal hernia
Figure 4)
Figure 4)
A Axial T2-weighted magnetic resonance enterography image demonstrating a long segment of narrowing (thin arrow) distal to an ileoileal anastomosis (thick arrow) without evidence of active inflammation. B Computed tomography imaging performed 12 h later showing diffuse dilation of the small bowel with fecalization of bowel content (arrowheads) and a transition point at the narrowed segment of bowel demonstrated on magnetic resonance enterography (thin arrow)
See this image and copyright information in PMC

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