Manometrically guided colon insufflation during double-contrast barium enemas.

The double-contrast enema's potential for high accuracy depends in part on consistently good inflation of the colon. However, optimal inflation is often not obtained because of deflation during filming, underinflation because of fear of perforating the colon, or patient discomfort. To help meet the dual requirements of ensuring consistently good bowel inflation while avoiding over-inflation, we have designed a modified insufflator which incorporates a manometer and allows accurate readings of intraluminal large-bowel pressures during or following insufflation. In more than 3000 examinations using this method we have experienced no complications.

Use of a tracer dose of barium for evaluating bowel preparation.

Residual colonic barium can be used to gauge bowel preparation for barium enemas. Because upper gastrointestinal study frequently does not immediately precede the barium enema, we have adopted the technique of administering a tracer dose of barium at the beginning of bowel preparation. This report discusses the method, results, advantages, and disadvantages of this technique.

Colonic polyp detection: role of roentgenography and colonoscopy.

In order to determine the relative yields of colonoscopic and radiologic examinations of the colon, the following guidelines are suggested: (a) prospective data collection; (b) a standard, effective colon cleansing regimen; (c) colonoscopic and radiologic examiners of comparable expertise; (d) examiners should be unaware of each other's findings; (e) a suitable method for demonstrating false-negative findings and for resolving conflicting findings between the two examinations; and (f) indexing of the study findings as to lesion size, lesion location, quality of colon cleansing, and examiner's level of confidence. The two examinations should be used as complementary diagnostic procedures.