Barium Enema Findings of Milk Allergy in Infants

PURPOSE: We wanted to evaluate the barium enema findings of milk allergy in infants. MATERIALS AND METHODS: Retrospective evaluation of the plain abdominal radiography and barium enema findings was performed in fifteen young infants suffering with milk allergy. The presence of gaseous distension, rectal gas, paralytic ileus and mechanical obstruction was evaluated on the plain radiography. The presence of spasm, a transitional zone, a reversed rectosigmoid index and mucosal irregularity was analyzed on the barium enema; the presence of barium retention was also evaluated on 24-hour-delayed plain radiography. RESULTS: Paralytic ileus was the most common finding on the plain radiography (93%). On the barium enema, continuous spasm of the colon, ranging from the rectum to the descending colon, was revealed in ten infants (67%). A transitional zone was observed in one infant and a reversed rectosigmoid index was revealed in four. Mucosal irregularity was observed in two infants. Barium retention was demonstrated in 11 of fifteen cases: throughout the entire colon (n = 3), from the rectum to the descending colon (n = 7), and up to the transverse colon (n = 1). CONCLUSION: The most common barium enema finding of milk allergy in infants was spasm of the distal colon. The other findings were a transitional zone, a reversed rectosigmoid index, mucosal irregularity and barium retention.

Barium Enema Findings of Milk Allergy in Infants

PURPOSE: We wanted to evaluate the barium enema findings of milk allergy in infants. MATERIALS AND METHODS: Retrospective evaluation of the plain abdominal radiography and barium enema findings was performed in fifteen young infants suffering with milk allergy. The presence of gaseous distension, rectal gas, paralytic ileus and mechanical obstruction was evaluated on the plain radiography. The presence of spasm, a transitional zone, a reversed rectosigmoid index and mucosal irregularity was analyzed on the barium enema; the presence of barium retention was also evaluated on 24-hour-delayed plain radiography. RESULTS: Paralytic ileus was the most common finding on the plain radiography (93%). On the barium enema, continuous spasm of the colon, ranging from the rectum to the descending colon, was revealed in ten infants (67%). A transitional zone was observed in one infant and a reversed rectosigmoid index was revealed in four. Mucosal irregularity was observed in two infants. Barium retention was demonstrated in 11 of fifteen cases: throughout the entire colon (n = 3), from the rectum to the descending colon (n = 7), and up to the transverse colon (n = 1). CONCLUSION: The most common barium enema finding of milk allergy in infants was spasm of the distal colon. The other findings were a transitional zone, a reversed rectosigmoid index, mucosal irregularity and barium retention.

Differentiation of Tuberculous Enteritis and Crohn's Disease with Barium Study Using Bayes Theory

PURPOSE: To differentiate tuberculous enteritis and Crohn's disease with barium study using Bayes theory. MATERIALS AND METHODS: The study group consisted of 34 patients with tuberculous enteritis (age range 16-86 years, mean age 43.3 years, M:F=19:15) and 36 patients with Crohn's disease (age range 19-78 years, mean age 35.2 years, M:F=18:18). These diagnoses were confirmed by therapeutic tests (tuberculous enteritis: 15, Crohn's disease:16) or histopathological examinations (tuberculous enteritis: 19, Crohn's disease: 20) conducted from January 1993 to May 2003. Three radiologists (two abdominal specialists and one trainee) analyzed each radiological finding of tuberculous enteritis and Crohn's disease by means of a barium enema and/or small bowel series. We used Fisher's exact test to verify the statistical significance of each radiological finding and p-values less than 0.05 were considered to be significant. We calculated the likelihood ratio (LR) of tuberculous enteritis versus Crohn's disease for each finding by employing Bayes theory. RESULTS: The radiological findings associated with a high likelihood ratio for tuberculous enteritis were the involvement of the cecum (LR=2.65) and ascending colon (LR=1.99), rigid narrowing (LR=1.94), shortening of the bowel (LR=1.99), haustral loss (LR=1.97) and sacculation (LR=3.88). The radiological findings associated with a high LR for Crohn's disease (low LR for tuberculous enteritis) were age between 20 and 29 years (LR=0.53), the involvement of the jejunum (LR=0.12), terminal ileum (LR=0.19), sigmoid colon (LR=0.30) or rectum (LR=0.17), and the presence of skip lesions (LR=0.19) or strictures (LR=0.21). With these LRs, the probability of the subject having tuberculous enteritis versus Crohn's disease could be calculated using Bayes theory. CONCLUSION: The analysis of a barium study using Bayes theory could provide an objective, easy and fast method of differentiating tuberculous enteritis and Crohn's disease.

A Randomized Prospective Trial Comparing Oral Sodium Phosphate with Magnesium citrate in Preparing of Patients for Double Contrast Barium Enema

PURPOSE: The purpose of this study was to compare two bowel preparation agents, sodium phosphate solution with magnesium citrate solution. MATERIALS AND METHODS: A total of 94 subjects that underwent a double-contrast barium enema were included in this study. Bowel preparation before performing the barium study was done by using a sodium phosphate solution in 47 subjects and by using a magnesium citrate solution in the other 47subjects. We evaluated the presence or absence of side effects when using these bowel preparation agents. Two radiologist who were blinded to the type of bowel preparation evaluated the quality of bowel preparation at the colonic segments (ascending, descending, and sigmoid colon) on the radiographs obtained by double-contrast barium enema, with regard to stool cleansing, water retention, barium coating and bubble formation. RESULTS: The side effects, such as abdominal clamping pain, nausea, hunger pain and chill occurred more frequently in the sodium phosphate group than in the magnesium citrate group (p<0.001). Stool retention was more frequently found in the magnesium citrate group (p<0.001). However, no statistical difference was noted on the status of water retention and barium coating between two groups. Gas bubble formation was more commonly seen in the sodium phosphate group (p<0.001). The sodium phosphate solution appeared to be more effective in cleansing the right colon (p=0.001). CONCLUSION: Sodium phosphate solution appears to be more effective for colonic cleansing, with a lower incidence of side effects, than when using magnesium citrate solution.

Primary Lymphoma of the Colon: Radiologic and Pathologic Findings

Compared with the stomach and small intestine, the colon and rectum are uncommon sites of lymphomatous involvement. Primary colorectal lymphoma is diagnosed when the lesion is confined to the colorectal area and regional lymph nodes, without involvement of other organs including the upper gastrointestinal tract, bone marrow, and distant lymph nodes. The radiologic appearance of primary lymphoma of the stomach and small bowel is well known, but in cases involving the colorectal area, this is not so. In this article, we categorize and illustrate the radiologic manifestations of primary colorectal lymphoma according to the findings of double-contrast barium enema and CT images, and describe the pathologic findings.

Early Colon Cancer: Findings on Double Contrast Barium Enema

PURPOSE: To describe the radiologic findings of early colon cancer on double-contrast barium enema. MATERIALS AND METHODS: We retrospectively reviewed the double-contrast barium enemas of eight patients (M:F=6:2;mean age:67yrs;range:48-77 yrs) who were pathologically proven to be early colon cancer. The location, size and grossmorphology of lesions was evaluated using double-con-trast barium enema, while depth of invasion, degree ofdifferentiation, precancerous lesions and lymph node metastasis were evaluated histopathologically. RESULTS:Early colon cancer was found in the rectum(n=4), sigmoid colon (n=3) and ascending colon(n=1). The size of massranged from 2.3-8.3(mean, 4.6)cm. And the polypoid type was most common(n=7);this was subdivided into sessile(IS,n=5), semipedunculated (ISP, n=1) and pedunculated type(Ip, n=1). Another mass was a sessile polypoid combinedwith a flat depressed lesion. In eight cases, four cancers were confined to the mucosa, while the remaining fourhad infiltrated the submucosa. Most cancers arose from villous and villotubular adenoma. All cases werewell-differentiated adenocarcinoma and no metastasis to lymph nodes had occurred. CONCLUSION: In early coloncancer, lesions were mainly polypoid and large. Most arose from villous and villotubular adenoma.

Degree of Mucosal Coating on Double Contrast Barium Enema: Comparison of Distilled Water and Normal Saline as a Suspension

PURPOSE: To evaluate the degree of mucosal coating on double contrast barium enema (DCBE) using barium suspension made with distilled water or normal saline. MATERIALS AND METHODS: Between June 1 and July 30, 1996, fifty-four patients prospectively underwent DCBE using 83% w/v(weight-to-volme) of barium suspension (room temperature, 24 degrees), which was made with 1,200 mL of distilled water (Group 1 ; 29 cases) and normal saline (Group 2 ; 25 cases) per 1 Kg of Solotopr (Taejoon Pharmacy, Seoul, Korea). Bowel preparation and examination methods were the same in both groups, and four projections (erect view, supine view, both decubitus views) were taken. The mucosal coating was graded as excellent, good, ordinary, or poor by three radiologists working independently, and scored from 3 to 0. Significance was analyzed by t-test. RESULTS: Mean grading scores 2.33+/-0.70 in group 1 and1.56+/-0.99 in group 2 (P < 0.003). CONCLUSION: When barium suspension made with distilled water was used, the degree of mucosal coating on DCBE was better than when the suspension was made with normal saline.