A barium enema is a radiological examination of the rectum and the entire colon. The barium enema has been used for many years to diagnose polyps and colon cancers. The complication rate with the procedure is very low; the rate of perforation is one in 25,000 examinations.
A single contrast exam is usually not sensitive enough and has been replaced by the double contrast barium enema is a diagnostic procedure that can provide important information about colonic stricture or obstruction
Before the barium X-ray is administered, the patient may have to undergo a preparation that includes a liquid diet and enemas, cathartics, to clear stool from the colon. This preparation may differ from exam to exam, and from one physician to another.
Before the exam takes place, a barium preparation (a contrast agent) is administered through a rectal tube. No sedation is required.
|Patient positioning and room set-up for a barium enema X-ray|
The entire colon may be examined, although overlapping loops of the bowel and the flexures are difficult areas to interpret. The sensitivity of a double contrast barium enema ranges from 39% to 90%. The addition of a flexible sigmoidoscopy to a double contrast barium enema improves the diagnostic yield.
|Colonic features and corresponding barium enema X-rays. A: carcinoma in the cecum; B: pedunculated polyp; C: apple core lesion.|
The utility of double contrast barium radiography is dependent upon the skill of the radiologist in reading the subtleties of the resultant film. Successful studies are also dependent upon the patient’s preparation and cooperation during the procedure.
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