Postendoscopy barium enema examinations

A study was designed to evaluate whether sigmoidoscopy performed on the same day as barium enema examination interferes with quality or interpretation of the barium study. The study included 295 patients who had either single- or double-contrast barium enema examinations subsequent to sigmoidoscopy performed either on a prior day or the same day. Luminal air, spasm, colonic fluid, and mucosal coating were assessed, as was the resultant diagnostic quality of each barium examination. The results suggest that rigid or fiberoptic sigmoidoscopy can be performed the same day as single- or double-contrast barium enema examinations without adversely affecting the quality or interpretation of the barium study.     

Intra-individual comparison of patient acceptability of multidetector-row CT colonography and double-contrast barium enema

AIMS: To compare the subjective acceptability of CT colonography in comparison with barium enema in older symptomatic patients, and to ascertain preferences for future colonic investigation. MATERIALS AND METHODS: The study population comprised 78 persons aged 60 years or over with symptoms suggestive of colorectal neoplasia, who underwent CT colonography followed the same day by barium enema. A 25-point questionnaire was administered after each procedure and an additional follow-up questionnaire a week later. Responses were compared using Wilcoxon matched pairs testing, Mann-Whitney test statistics and binomial exact testing. RESULTS: Participants suffered less physical discomfort during CT colonography (p = 0.03) and overall satisfaction was greater compared with barium enema (p = 0.03). On follow-up, respondents reported significantly better tolerance of CT colonography (p = 0.002), and were less prepared to undergo barium enema again (p < 0.001). Of 52 subjects expressing an opinion, all preferred CT to barium enema. CONCLUSION: Patient satisfaction was higher with CT colonography than barium enema. CT colonography caused significantly less physical discomfort and was overwhelmingly preferred by patients.     

Predictability of rectal incontinence on barium enema examination.

The aim of this study was to determine if digital assessment of anal sphincter tone predicts whether a rectal balloon is needed to prevent incontinence during a barium enema examination. During an 8 month , 306 patients scheduled for barium enema examination were evaluated. Immediately before each examination as good, fair, or poor. The barium enema was then performed in a conventional manner. Leakage of even small amounts of barium was scored as rectal incontinence. Ability to retain the barium enema correlated closely with the strength of rectal bone, regardless of patient sex or age. For different sphincter tones the incidence of rectal incontinence was: good, 2%, fair, 30%; and poor, 90%. From these findings it is recommended that, irrespective of patient age and sex, the use of rectal balloon catheters be limited to patients with poor or fair rectal tone.     

Barium enema following incomplete colonoscopy

The purpose of this article is to describe our findings on barium enema in patients who have had incomplete colonoscopy. For patients undergoing colonoscopy and barium enema within 6-months of each other between 1991 and 1997, barium enemas were reevaluated for redundant anatomy as well as lesions. Seventy-seven women and 30 men underwent 108 barium enemas. The most common finding was a redundant colon in 68% (55/81) of study patients, but only 33% (9/27) of control (complete colonoscopy) patients.     

Comparison of radiologists' confidence in excluding significant colorectal neoplasia with multidetector-row CT colonography compared with double contrast barium enema

The aim of this study was to compare the confidence of experienced radiologists in excluding colonic neoplasia with CT colonography (CTC) compared with barium enema. 78 patients (median age 70 years, range 61-87 years, 44 women) underwent same day CTC and barium enema. Two radiologists experienced in reporting barium enema assessed whether the examination had excluded a polyp 6 mm or greater as "yes", "probably" or "no" for each of 6 colonic segments. Two different radiologists experienced in CTC independently performed the same assessment on the CT datasets. Responses were compared using a paired exact test. Formal barium enema and CT reports were compared with any endoscopic examination performed within 1 year. Studies reporting polyps 6 mm+ in patients not subsequently undergoing endoscopy were reviewed by two independent observers. Radiologists stated they had confidently excluded a significant lesion in 314 (71%) and 382 (86%) of 444 segments with barium enema and CTC, respectively (p<0.001). Confidence was significantly higher with CTC in the in the descending and ascending colon (p = 0.02 and p<0.001, respectively), and caecum (p<0.001). 22 patients underwent some form of endoscopy. Of five patients with proven colorectal neoplasia (including two with cancer), CTC and barium enema correctly identified five and three, respectively. In 56 patients not undergoing endoscopy, CTC reported 17 polyps 6 mm+, of which 16 were retrospectively classified as definite or probable. 11 could not be identified on the barium enema, even in retrospect. Confidence in excluding polyps 6 mm or larger is significantly greater with CT colonography particularly in the proximal colon.     

Cost-effectiveness of colorectal cancer screening

PURPOSE: To determine the most cost-effective colorectal cancer screening strategy costing less than $100,000 per life-year saved and to determine how available strategies compare with each other. MATERIALS AND METHODS: Standardized methods were used to calculate incremental cost-effectiveness ratios (ICERs) from published estimates of cost and effectiveness of colorectal cancer screening strategies, and the direction and magnitude of any effect on the ratio from parameter estimate adjustments based on literature values were estimated. RESULTS: Strategies in which double-contrast barium enema examination was performed emerged as optimal from all studies included. In average-risk individuals, screening with double-contrast barium enema examination every 3 years, or every 5 years with annual fecal occult blood testing, had an ICER of less than $55,600 per life-year saved. However, double-contrast barium enema examination screening every 3 years plus annual fecal occult blood testing had an ICER of more than $100,000 per life-year saved. Colonoscopic screening had an ICER of more than $100,000 per life-year saved, was dominated by other screening strategies, and offered less benefit than did double-contrast barium enema examination screening. CONCLUSION: Double-contrast barium enema examination can be a cost-effective component of colorectal cancer screening, but further modeling efforts are necessary.     

早期结肠癌低张气钡双对比造影检查与纤维结肠镜对比分析

目的:对于早期结肠癌的检查,通过低张气钡双对比造影(DCBE)图像与纤维结肠镜检查图像对比观察,分析气钡双对比结肠造影在检出早期结肠癌中的价值。方法:20例经病理证实早期结肠癌病例,采用低张气钡双对比造影方法,实时点片。常规纤维结肠镜检查。结果:Ⅰ型11例,Ⅱa型6例,混合型1例,LST型2例,对比观察造影像及内镜像表现。结论:正确运用气钡双对比造影检查,对早期结肠癌的显示有较大价值。     

Single-contrast vs double-contrast barium enema in the detection of colonic polyps

Radiographic and colonoscopic correlation in 139 patients with 234 colonic polyps compared the sensitivity of single- and double-contrast barium enema. Single-contrast barium enema detected 68 (80%) of polyps, with 72% of polyps under 1 cm and 94% of those 1 cm or over detected. Double-contrast barium enema detected 135 (91%) of 149 polyps, with 88% of polyps under 1 cm and 96% of larger polyps detected. Thus, the double-contrast barium enema was more effective than the single-contrast examination only for detection of polyps under 1 cm. The single-contrast barium enema was more likely performed on patients in poor physical condition and in those over 70 years old. The results suggest that for elderly patients, who may have difficulty in cooperating for a double-contrast enema, a properly performed single-contrast examination is an acceptable option.     

功能性出口梗阻性便秘的影像学研究进展

出口梗阻性便秘（OOC）是一种女性患者的常见病,尤其多见于经产妇,早期而准确的诊断是治疗的关键。对于该疾病有多种影像学诊断方法,包括钡灌肠、结肠传输功能试验、直肠排粪造影、气钡双对比灌肠联合直肠排粪造影、仿真直肠排粪造影等。本文综述了各种影像学检查的优缺点及应用进展。     

钡灌肠对结肠癌的X线诊断价值(附8例对照分析)

目的 钡灌肠是诊断大肠病变的最基本检查方法，结合文献复习探讨钡灌肠X线检查结肠癌的价值。方法 对8例钡灌肠患者进行回顾性分析，观察X线诊断大肠癌的可靠征象，分析钡灌肠的优势及局限性。结果 钡灌肠8例，结肠癌3例并与CT诊断、电子肠镜检查、手术所见对照。结论 钡灌肠对诊断大肠病变有其重要的价值。     

针灸配合气或钡灌肠整复小儿肠套叠的研究

目的:提出针灸配合透视下灌肠治疗小儿肠套叠的方法,探讨针灸配合气或钡灌肠在整复小儿肠套叠 中的价值。方法:取足三里、合谷、天枢、关元、中脘等穴位,毫针直刺,深度0.5～1寸,用泻法,针后配合气或钡灌 肠治疗小儿肠套叠;并与传统气、钡灌肠整复肠套叠的成功率作对比。结果:试验组气或钡灌肠各32例,成功率分 别是31/32(96.9%)、30/32(93.7%),对照组气或钡灌肠各30例,成功率分别是26/30(86.6%)、25/30(83.3%)。 结论:气或钡灌肠结合针灸对整复小儿肠套叠较单纯灌肠整复率高,可作为小儿肠套叠治疗的首选方法。     

Feasibility of instructing radiology technologists in the performance of gastrointestinal fluoroscopy

OBJECTIVE: We sought to determine if dedicated gastrointestinal technologists could be trained to properly perform esophagography and double-contrast barium enema examinations. SUBJECTS AND METHODS: Ninety-four patients undergoing double-contrast barium enema examinations and 123 patients undergoing esophagographic examinations were included in the study. The study was conducted over a 4-month period, with examinations performed by eight gastrointestinal technologists, 10 radiology residents, and four staff radiologists. Four random lists were generated for each set of examinations. Each staff gastrointestinal radiologist, who was unaware of who had performed the examination, independently scored the representative radiographs. RESULTS: For the double-contrast barium enema examinations, no statistically significant differences were found between the technologists and residents for amount of barium used, degree of distention, cecal opacification, and quality of spot radiographs. The technologist-performed examinations had a statistically significant lower mean fluoroscopy time (3.2 min, compared with 4.0 min for staff radiologists and 5.7 min for residents). For the esophagrams, no statistically significant differences between technologists and residents were found for single-contrast esophagrams; radiographs of the gastric cardia; assessment of motility, reflux, and transit of a solid bolus; and fluoroscopy time. Double-contrast esophagrams obtained by technologists received a better mean score than did those of the residents. CONCLUSION: Radiology technologists can be trained to perform high-quality esophagography and double-contrast barium enema examinations without an unacceptably high radiation dose.     

A comparison of mannitol and magnesium citrate preparations for double-contrast barium enema

Three preparations, two based on magnesium citrate and one an optimised oral mannitol regime, have been compared for their effectiveness in clearing the large bowel prior to double-contrast barium enema and for effects on barium mucosal coating. If excellent clearance alone is taken as the criterion of acceptability, the preparations based on magnesium citrate are shown to be equal to each other, but better than mannitol. No significant difference in coating performance is seen between the three preparations. Magnesium citrate regimes cause significantly less nausea and vomiting than mannitol. No differences are noted in the frequency of abdominal or rectal pain between the preparations. It is concluded that mannitol should be abandoned as a barium enema preparation.     

儿童结肠息肉的X线诊断与造影方法(附24例报告)

目的 :探讨 X线造影的技术方法 ,提高儿童结肠息肉的检出率。方法 :2 4例 ,男 1 5例、女 9例 ,年龄 3～ 1 2岁 ,手术证实。采用钡气双重造影并与单纯钡剂造影作对比。结果 :2 4例病例中 ,单纯钡剂造影仅显示 7例 (2 9% ) ,但钡剂双重造影显示 2 4例 ,其中无蒂息肉 1 5例 (62 % ) ,有蒂息肉 9例 (38% )。“靶征”及“礼帽征”是结肠息肉的特异 X线征象。结论 :单纯钡剂造影有一定诊断价值 ,但易造成漏诊。钡气双重造影检出率远远高于单纯钡剂造影检出率     

Glucagon and barium enema examinations: a controlled clinical trial.

In a double-blind crossover clinical trial, 10 healthy volunteers received placebo and 2 mg glucagon intramuscularly preceding barium enema examination on separate days. In addition, 50 patients were given either placebo or 2 mg glucagon prior to barium enema examination in a double-blind study. The results of 38 variables determined on each study population were similar. When glucagon was given, both the patients and examiners noted significantly less discomfort and more bowel relaxation. There were no significant changes in pulse, blood pressure, or electrocardiogram. Adverse reactions did not occur frequently enough to allow confident comparison of placebo and glucagon. It is concluded that the use of glucagon can provide a more comfortable barium examination with acceptable safety.     

腹茧症的X线诊断

目的: 探讨腹茧症小肠钡剂造影的X线诊断.材料和方法: 回顾性分析6例经手术证实的腹茧症小肠钡剂造影的X线表现.结果: 钡餐或小肠灌肠造影表现为受累小肠肠管往返盘绕排列,呈"手风琴"状,近段肠管扩张,钡剂通过延迟.术中发现小肠广泛粘连,肠管被膜状物包裹成团,似蚕茧状.病理组织学显示膜状物为增生的纤维结缔组织.结论: 小肠蚕茧状包裹征是一种原因不明少见病,小肠钡剂造影有特征性表现,结合临床可于术前诊断.     

What happens to patients after upper and lower gastrointestinal tract barium studies?

We investigated the occurrence of new constipation, diarrhea, nausea, vomiting, visible blood in stool, abdominal pain, black stools, belching, and flatus in 324 outpatients following upper or lower gastrointestinal tract barium procedures. We also evaluated the roles of age, sex, patient mobility, and types of barium enema (single- or double-contrast). At least one new symptom was reported after 51% of all examinations. Constipation was the most frequently reported single symptom after barium meal or small bowel examinations. Fifty percent of all constipation occurred following upper gastrointestinal examinations. Abdominal pain was common in patients of the seventh decade, especially following barium enema. Nausea typically followed barium swallow or upper gastrointestinal series. Belching and passage of flatus were the most frequently reported symptoms after barium enema, both single- and double-contrast. No significant relationship between the frequency of symptoms and patient age, sex, or the type of barium enema was established.     

儿童克隆病的X线诊断

目的：探讨传统X线检查方法对儿童克隆病的诊断及其X线征象,以提高该病的X线检查诊断率,方法：28例行肠系钡餐和／或钡灌肠检查诊断为克隆病的患儿,经手术和病理学确诊13例,比较各种X线检查方法的诊断特异性及分析儿童克隆病的X线特征。结果：肠系钡餐对克隆病的诊断特异性为36．3％,钡灌肠为20．0％,两者联合应用诊断特异性显著提高达66．7％,儿童克隆病的X线特征易与肠结核,淋巴昆淆,结论：加强对和童克隆的重视,提高对X线征象的认识,以及联合应用肠系钡餐及钡灌肠检查方法将有助于克隆病诊断率的提高。     

结肠镜与钡灌肠检查在直肠癌诊疗中比较

目的：比较钡灌肠和纤维结肠镜在直肠癌诊治中的作用。方法：本研究对北京肿瘤医院1996年4月-1999年12月住院的直肠癌手术病人进行回顾性分析，共收集资料全面同时进行纤维结肠镜和钡灌肠检查的病人51例进行分析，对比两种检查方式对于直肠肿瘤及合并结肠疾病的诊断。结果：在51例直肠癌中，钡灌肠检查时漏诊2例，对于纤维结肠镜检查发现的8例合并存在的结肠息肉全部漏诊。结论：在直肠癌的术前检查中纤维结肠镜检查应该作为常规的检查项目，而钡灌肠检查除非特殊情况下，一般不宜用这种方法检查同时合并的结肠病变。