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Nursing Times
Review
Topics: Administration, Rectal; Barium Sulfate; Colonic Diseases; Contrast Media; Enema; Humans; Radiography
PubMed: 14528755
DOI: No ID Found -
Best Practice & Research. Clinical... Mar 2021Double-contrast barium enema (DCBE), transrectal endoscopic ultrasonography (REU), multidetector computerized tomography enema (MDCT-e), and computed tomography... (Review)
Review
Double-contrast barium enema (DCBE), transrectal endoscopic ultrasonography (REU), multidetector computerized tomography enema (MDCT-e), and computed tomography colonoscopy (CTC) have been successfully used for the diagnosis of bowel endometriosis. DCBE provides a complete overview of the entire colon and allows detecting cecal nodules. The accuracy of DCBE is operator dependent and, thus, it may have low specificity. It does not allow identifying the cause of the mass effect. DCBE requires the administration of barium and exposure to radiation. REU precisely estimates the distance between the rectosigmoid nodule and the anal verge. However, it allows investigating only the distal part of rectosigmoid, it misses anterior pelvic lesions, and it has poor sensitivity for the diagnosis of endometriomas. MDCT-e is accurate and reproducible in diagnosing intestinal endometriosis and in assessing its characteristics: the largest diameter of the nodule, the distance between the distal part of the nodule and the anal verge, and depth of infiltration of endometriosis in the intestinal wall. MDCT-e requires the administration of iodinated contrast medium (CM) and the exposure to radiations. CTC has good performance in the diagnosis of rectosigmoid endometriosis. It allows estimating the degree of intestinal stenosis CTC, and the distance between the intestinal endometriotic nodule and the anal verge. It requires exposure to radiations, and it may require the administration of an iodinated CM.
Topics: Barium Enema; Colonoscopy; Endometriosis; Endosonography; Enema; Female; Humans; Sensitivity and Specificity; Tomography, X-Ray Computed
PubMed: 32698994
DOI: 10.1016/j.bpobgyn.2020.05.011 -
Radiology Jun 2000This review article presents the principles for performing a safe, comfortable, and accurate double-contrast barium enema examination. The procedure is a flexible... (Review)
Review
This review article presents the principles for performing a safe, comfortable, and accurate double-contrast barium enema examination. The procedure is a flexible examination in which the fluoroscopist interacts with the patient, the controls of the fluoroscope, and the image on the television monitor. During a double-contrast examination, images of the colon are created by manipulating the patient, the barium pool, and the amount of air insufflated into the rectum. Fluoroscopy is essential for guiding the radiologist to obtain spot images with adequate technical factors. The fluoroscopist analyzes the luminal contour, the barium-coated mucosal surface en face, and the barium pool to detect abnormalities in the colon. With careful technique, a high-quality examination can be performed in most patients.
Topics: Barium Sulfate; Colon; Contrast Media; Enema; Fluoroscopy; Humans; Insufflation
PubMed: 10831679
DOI: 10.1148/radiology.215.3.r00jn36642 -
BMC Pediatrics Oct 2020Preoperative diagnosis of total colonic aganglionosis is important for the rational choice of treatment. The present study aimed to evaluate the diagnostic performance...
BACKGROUND
Preoperative diagnosis of total colonic aganglionosis is important for the rational choice of treatment. The present study aimed to evaluate the diagnostic performance of radiographic signs on preoperative barium enema in patients with total colonic aganglionosis.
METHODS
Forty-four patients [41 (3-659) days] with total colonic aganglionosis, including 17 neonatal patients, who received preoperative barium enema at Beijing Children's Hospital, from January 2007 to December 2019 were included. All radiographs were retrospectively restudied by 2 pediatric radiologists to ascertain radiographic signs including rectosigmoid index, transition zone, irregular contraction, gas-filled small bowel, microcolon, question-mark-shaped colon and ileocecal valve reflux. Kappa test was performed to assess the accuracy and consistency of the radiographic signs.
RESULTS
The 2 radiologists showed slight agreement for gas-filled small bowel, microcolon and rectosigmoid index, fair agreement for transition zone and irregular contraction, and moderate agreement for question-mark-shaped colon and ileocecal valve reflux (Kappa values, 0.043, 0.075, 0.103, 0.244, 0.397, 0.458 and 0.545, respectively). In neonatal patients, the 2 radiologists showed moderate agreement for ileocecal valve reflux and substantial agreement for question-mark-shaped colon (Kappa values, 0.469 and 0.667, respectively). In non-neonatal patients, the 2 radiologists showed substantial agreement for ileocecal valve reflux (Kappa value, 0.628). In 36 patients with total colonic aganglionosis extending to the ileum, the accuracies of question-mark-shaped colon, ileocecal valve reflux and the combination of both were 47%, 53%, and 75%, respectively, in one radiologist and 53%, 50% and 72%, respectively, in the other radiologist.
CONCLUSIONS
Ileocecal valve reflux is a relatively reliable radiographic sign for diagnosing total colonic aganglionosis and could improve the diagnostic accuracy upon combination with question-mark-shaped colon.
Topics: Barium Enema; Child; Enema; Hirschsprung Disease; Humans; Infant, Newborn; Retrospective Studies
PubMed: 33126876
DOI: 10.1186/s12887-020-02403-3 -
Journal of Pediatric Gastroenterology... Apr 2019To analyse the diagnostic capacity of barium enema (BE) in the diagnostic investigation for Hirschsprung's disease (HD) was analyzed for transition zone (TZ)...
OBJECTIVE
To analyse the diagnostic capacity of barium enema (BE) in the diagnostic investigation for Hirschsprung's disease (HD) was analyzed for transition zone (TZ) identification and rectosigmoid index (RSI) ≤1.0 determination.
PATIENTS AND METHODS
BE images were analyzed retrospectively by 2 examiners and the results were compared with the histopathology of rectal biopsies.
RESULTS
TZ identification and RSI ≤1.0 were assessed separately and combined in 43 patients. Twelve (27.9%) patients had the diagnosis of HD based on rectal biopsies. TZ identification presented better diagnostic capacity for the 2 examiners than RSI ≤1.0. However, interexaminer agreement was higher for RSI ≤1.0 than for TZ identification. The combination of TZ identification and RSI ≤1.0 increased the sensitivity (83.3%-92.3%) and the negative predictive value (90.4%-92.3%).
CONCLUSION
Therefore, the high diagnostic sensitivity of TZ identification combined to RSI ≤1.0 reinforces the usefulness of these BE parameters in the screening for Hirschsprung's disease.
Topics: Barium Enema; Child, Preschool; Colon, Sigmoid; Female; Hirschsprung Disease; Humans; Infant; Male; Rectum; Retrospective Studies; Sensitivity and Specificity
PubMed: 30628984
DOI: 10.1097/MPG.0000000000002242 -
Clinical Radiology May 2001To analyse sensitivity, specificity and complication rate of endoscopy, and barium enema for the detection of colorectal neoplasia. (Comparative Study)
Comparative Study Review
AIM
To analyse sensitivity, specificity and complication rate of endoscopy, and barium enema for the detection of colorectal neoplasia.
MATERIALS AND METHODS
A MEDLINE search was performed (1980-2000) directed at the endoscopic and radiologic literature on barium enema. Articles were selected based on the type of study, availability of sensitivity and specificity values in sizeable patient groups, and reports on complications. Sixty articles were included in the analysis.
RESULTS
Endoscopy proved to have superior sensitivity for polyps in patients at high-risk for colorectal neoplasia. The role of endoscopy and radiology in average-risk screening populations is not known. Sensitivity and specificity rates ranged widely, probably due to bias. For the detection of small polyps endoscopy has superior performance, whereas sensitivity is similar for endoscopy and barium enema for the detection of larger (>1 cm) polyps and tumours. Overall, endoscopy is associated with a higher complication rate.
CONCLUSION
Endoscopy is the preferred detection method in high-risk patients. The role of endoscopy and radiology in a screening setting requires evaluation. This review provides the test characteristics of endoscopy and radiology which are relevant for a cost-effectiveness analysis. Double-contrast barium enema may play an important role for screening purposes, owing to its good sensitivity for detecting larger (>1 cm) polyps and its lack of major complications. de Zwart, I. M.et al. (2001). Clinical Radiology56, 401-409.
Topics: Barium Sulfate; Bias; Colonoscopy; Colorectal Neoplasms; Enema; Humans; Sensitivity and Specificity
PubMed: 11384140
DOI: 10.1053/crad.2000.0672 -
Current Problems in Diagnostic Radiology 1991The barium enema is a safe and accurate diagnostic study of the colon but, in rare cases, complications may result. Many of these can be prevented by proper equipment... (Review)
Review
The barium enema is a safe and accurate diagnostic study of the colon but, in rare cases, complications may result. Many of these can be prevented by proper equipment and careful attention to technique. When a complication does occur, prompt recognition and management is vital in decreasing morbidity and mortality. Perforation of the bowel is the most frequent serious complication, occurring in approximately 0.02% to 0.04% of patients. Rarely the colon may burst due to excessive transmural pressure alone. However, a colon weakened by iatrogenic trauma or disease is more likely to perforate during an enema than is a normal healthy bowel. Injury to the rectal mucosa or anal canal due to the enema tip or retention balloon is probably the most common traumatic cause of barium enema perforation. Inflation of a retention balloon within a stricture, neoplasm, inflamed rectum, or colostomy stoma is particularly hazardous. Recent deep biopsy or polypectomy with electrocautery makes the bowel more vulnerable to rupture. The tensile strength of the bowel wall is impaired in elderly patients, patients receiving long-term steroid therapy, and in disease states including neoplasm, diverticulitis, inflammatory bowel disease, and ischemia. Intraperitoneal perforation leads to a severe, acute peritonitis with intravascular volume depletion. The ensuing shock may be rapidly fatal. Prompt fluid replacement and laparotomy are essential. If the patient survives the initial shock and sepsis, later complications caused by dense intraperitoneal adhesions may develop. Extraperitoneal perforation is usually less catastrophic but may result in pain, sepsis, cellulitis, abscess, rectal stricture, or fistula. Intramural extravasation often forms a persistent submucosal barium granuloma which may ulcerate or be mistaken for a neoplasm. The most dramatic complication of barium enema is venous intravasation of barium. Fortunately, this is quite rare as it may be immediately lethal. Most cases have been attributed to trauma from the enema tip or retention balloon, mucosal inflammation, or misplacement of the tip in the vagina. Bacteremia has been found in as many as 23% of patients following barium enema and, in rare cases, may cause symptomatic septicemia. Other less common complications include barium impaction, water intoxication, allergic reactions, and cardiac arrhythmias. Preparatory laxatives and cleansing enemas have been implicated in some instances of dehydration, rectal trauma, water intoxication, and perforation. Careful review of the indications for examination, previous radiographs, and clinical history will identify many of the patients at greater risk for complications so that appropriate precautions may be observed.(ABSTRACT TRUNCATED AT 400 WORDS)
Topics: Arrhythmias, Cardiac; Barium Sulfate; Colon; Drug Hypersensitivity; Enema; Extravasation of Diagnostic and Therapeutic Materials; Humans; Intestinal Perforation; Myocardial Infarction; Pain; Peritonitis; Radiography; Rectum; Sepsis; Water Intoxication
PubMed: 1889235
DOI: 10.1016/0363-0188(91)90017-v -
Gastrointestinal Endoscopy May 1980
Topics: Barium Sulfate; Colon; Enema; Humans; Radiography
PubMed: 7390114
DOI: 10.1016/s0016-5107(80)73329-1 -
Cancer Sep 1992The variability in the published results for colonoscopy and barium enema examinations is confusing. With both, optimum studies depend on meticulous preparation,... (Comparative Study)
Comparative Study Review
The variability in the published results for colonoscopy and barium enema examinations is confusing. With both, optimum studies depend on meticulous preparation, technical excellence, and operator proficiency. The equivalency of results and the lower cost of the radiologic study indicate that the double-contrast barium enema is the technique of choice for the examination of asymptomatic patients or symptomatic individuals without known antecedent disease. The relatively small difference between the cost of the double-contrast enema examination and sigmoidoscopy ($193 versus $135) suggests that it should replace the latter on the 3-5-year screening schedule because, on average, 50% more of the colon is examined by the barium study. It is a mistake to place colonoscopy and barium enema in competitive positions; the two methods ideally complement one another. The exclusion of significant pathologic findings by the double-contrast enema can be accepted, but the detection of abnormalities should be followed, when necessary, by colonoscopic verification and/or biopsy. The number of times both will be required are few. Radiologically demonstrated colon carcinomas seldom require biopsy verification, and 90% of all polyps are smaller than 5 mm in diameter with a negligible incidence of malignant transformation. When the examinations are used in the proper sequence, they provide a cost-effective approach to the early detection and control of cancer of the large bowel.
Topics: Adult; Barium Sulfate; Colonic Neoplasms; Colonoscopy; Enema; Humans; Middle Aged
PubMed: 1511375
DOI: 10.1002/1097-0142(19920901)70:3+<1272::aid-cncr2820701513>3.0.co;2-q -
Gastroenterologia Y Hepatologia Dec 2023
Topics: Humans; Barium Enema; Barium Sulfate; Colonic Diseases; Enema; Colonic Neoplasms
PubMed: 36584751
DOI: 10.1016/j.gastrohep.2022.12.009