Modification of the Bardex-Weber Enema Tube

Abstract

Administration of a barium enema sometimes poses a difficult problem in patients with severe spasm of the colon or poor sphincter control due to age or previous operative procedure. The Bardex-Weber enema tube is of great assistance but has the disadvantage that continuous traction on the tube is frequently necessary to avoid leakage. Conversely, a Colojector enema outfit requires that someone hold a sponge rubber ball against the anus. To overcome these objections, the obvious thing to do is to combine the two ideas. This can be done simply and with practically no expense by the following method. A solid rubber ball about 2 3/16 inches in diameter, such as can be bought for a dime, is put in a vise just tight enough to hold it steady. A hole is then bored through its center, with an 11/32-inch bit, to accommodate a No. 30 F enema tube. The end of a smooth jaw forceps is inserted through the hole and the two open ends of the enema tube are grasped and pulled through. Rubber cement is smeared on the tube over an area 2 1/2 inches long next to the inflated bag of the enema tube, and the solid ball is drawn over the cement until it is 1/8 inch from the bag. As soon as the cement is dry, the outfit is ready for use. With this apparatus, the tube is passed until the rubber ball is pressing snugly against the anal region. The bag is then inflated until the soft tissues between the ball and the bag are squeezed somewhat. This provides an effective self-retaining plug which requires neither traction nor pressure. If the patient is ambulatory, the main tubing can be clamped off and disconnected from the glass tubing, a few drops of fluid are wiped from the end of the tube, and he may walk to the toilet without any leakage of barium solution. The advantages of this modified enema tube will appeal especially to technicians.