Abstract
For many years, double contrast barium enema has been an effective way to evaluate the large bowel. With the development of the colonoscope, the role of barium enema has been questioned. However it is still useful in investigating patients with colorectal symptoms especially in the developing world where colonoscopy is widely unavailable and fraught with challenges in completely evaluating the colon. This study aimed at reviewing double contrast barium enema investigations in our centre. This was a retrospective study on patients who underwent double contrast barium enema at the Korle Bu Teaching Hospital from May 2003 to April 2007 on account of symptoms referable to the large bowel. A total of 362 investigation reports were studied, of which 205 were for males and 154 for females, the mean age of the patients was 55.3 years (S.D 15.3 years). Majority of the investigations, 228 (61.96%), were normal. Diverticular disease diagnosed in 88 (23.91%) cases was the commonest finding, followed by neoplasm 27 (7.34%) cases and Ulcerative colitis 6 (1.63%) cases, non-specific narrowing of the bowel in 4 (1.09%) and in 5 (1.36%) cases their investigations were inconclusive due to poor bowel preparation. Rectal bleeding was the most frequent symptom prompting barium enema studies. Double contrast barium enema study of the large bowel is an important evaluation of patients with colorectal symptoms. .
Highlights
For many years, barium enema was the only way to obtain a complete structural examination of the colon, short of surgery
Colonoscopy is currently the ideal investigative tool for the colon since it combines detection of lesions with biopsy and/or treatment. This notwithstanding, the role of double contrast barium enema in investigating patients with colorectal symptoms cannot be denigrated since it still has a permissive role in diagnosis
This is so when viewed against the background that in reported large series in general practice colonoscopy was infrequently employed to investigate the large bowel 3. It has been shown in our centre that only 30% of patients presenting with rectal bleeding had colonoscopy of which complete examination was achieved in 30%; the rest having to complete their investigation with the double contrast barium enema.[4]
Summary
Barium enema was the only way to obtain a complete structural examination of the colon, short of surgery. With the advent of fiberoptic technology and the widespread use of colonoscopy in the 1970s, the role of barium enema has been questioned.[1, 2] Colonoscopy is currently the ideal investigative tool for the colon since it combines detection of lesions with biopsy and/or treatment This notwithstanding, the role of double contrast barium enema in investigating patients with colorectal symptoms cannot be denigrated since it still has a permissive role in diagnosis. This is so when viewed against the background that in reported large series in general practice colonoscopy was infrequently employed to investigate the large bowel 3. The unflinching role of double contrast barium enema is further demonstrated in the role assigned to it in screening for colorectal carcinoma in the US guidelines for colorectal cancer screening.[7,8]
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