A comparative study of double contrast barium enema and colonoscopy for evaluation of rectal bleeding in children.

ABSTRACT

In pediatric age group, rectal bleeding is both common and distressing. Unlike in adults, very few studies comparing diagnostic efficacy of double contrast barium enema (DCBE) and Colonoscopy are available in children. A prospective study was performed to compare the diagnostic accuracy of high quality DCBE against colonoscopy in children with overt rectal bleeding. Fourty four children underwent flexible colonoscopy and DCBE independently. The final diagnosis was made after considering all investigations. Against this gold standard, the sensitivity and specificity of DCBE were 66.66% and 100% while that of colonoscopy 74.35% and 100% respectively. When assessing polypoidal lesions of colon, diagnostic yield of enema study was 86.20% as compared to 72.41% with colonoscopy. In colitis cases, the similar figures for enema and endoscopy were 53.84% and 76.92% respectively. The observed differences were statistically insignificant. No significant preparation, premedication or procedure related complications were encountered. The study thus highlights the utility and complementary role of DCBE and colonoscopy for evaluation of children with rectal bleeding.