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Comparison of diagnostic tests used in the evaluation of suspected small bowel tumors

Diagnostic test	Advantages	Disadvantages
Plain abdominal film	May show obstruction	Nonspecific
Upper gastrointestinal series/small bowel follow through	May show mass lesion, mucosal defect, or intussusception	No visualization outside lumen; not helpful in staging
CT scan, including CT enterography	Allows staging (extraluminal findings); may aid in diagnosis of tumor type	Inferior to direct visualization for assessment of the bowel lumen
MR enterography	Same as CT enterography, except limits exposure to medical radiation	Inferior to direct visualization for assessment of the bowel lumen
Upper endoscopy	Direct visualization of mucosal surface of duodenum; allows for biopsy; polypectomy possible	Invasive; limited to duodenum
Push enteroscopy	Extends visualization into proximal jejunum; allows for biopsy	Invasive; does not permit visualization of the entire small bowel (no visualization beyond proximal jejunum)
Double-balloon enteroscopy	Allows visualization of entire small bowel with capacity for biopsy and therapeutic intervention	Invasive; not widely available; small risk of pancreatitis; latex composition of balloons
Single-balloon enteroscopy	Same as double-balloon enteroscopy; more widely available	Lower total enteroscopy rate; more limited depth of insertion
Spiral enteroscopy	Same as single-balloon enteroscopy	Limited availability
Wireless video capsule endoscopy	Noninvasive	Does not permit tissue sampling; should not be performed if small bowel obstruction suspected

CT: computed tomography.

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