The use of water-soluble contrast enema without pretreatment for the diagnosis of colon disease.

Abstract

Conventional colonoscopy and barium enema are the main examinations for colonic lesions, but each of them has different limitations according to the condition of the patient. It has been reported that preparations for these examinations also caused complications, such as colonic perforation leading to fatality. To avoid these complications, colonic enema with water-soluble contrast medium (Gatrografin) has been performed as a screening method for those suspected to have obstructive colonic diseases, or those in whom it was difficult to be form colonoscopy and barium enema because of their poor condition. There are few reports about water-soluble contrast enema (WSCE). We retrospectively examined 121 cases of WSCE performed from January 2004 to December 2005 and assessed the acceptability of examination and its ability to detect colonic lesions. We divided our patients into five groups according to the reason for performing WSCE. In all cases, we were able to perform WSCE without complications and assess colonic lesions. In 58 cases, we compared the results of WSCE with those of barium enema or colonoscopy, or both In 8 cases we missed small colonic polyps and erosions, but we missed only one large polyp 3 cm in diameter, which we detected retrospectively. In conclusion, WSCE is safe and useful for the diagnosis of colonic disease, and may be one of the choices of colonic examination especially for those who are suspected to have obstructive colonic diseases or hemorrhagic lesions as well as for those in whom it is difficult to perform barium enema or colonoscopy.