Underwent Barium Enema Research Articles

Chronic ulcerative colitis and colon cancer: can radiographic appearance predict survival patterns?

Twenty-four patients with chronic ulcerative colitis and colon carcinoma who underwent barium enema examination prior to the diagnosis of cancer were studied in an attempt to correlate the radiographic appearance of the tumors with their biologic behavior, as well as to assess the accuracy of the barium enema in detection. Of the radiographically detected tumors, 65% displayed an annular infiltrative appearance, with the prime radiographic manifestation being relative nondistensibility of the involved segment. The remaining tumors had various appearances more typical of noncolitic colon cancer. Patients with infiltrative lesions had a much poorer prognosis than those with noninfiltrative lesions. Of 33 gross tumors described pathologically and/or surgically, only 70% were correctly detected by barium enema. It is suggested that periodic barium enema examinations are an unreliable means of following patients with ulcerative colitis if malignant degeneration is to be detected at an early and curative stage. Prophylactic proctocolectomy may be the best therapeutic approach.

Frequency of proctoscopy in hospitalized patients undergoing barium enema

Frequency of proctoscopy in hospitalized patients undergoing barium enema

Bacteremia during barium enema study

The occurrence of bacteremia was studied in patients undergoing barium enema. Blood cultures were done on 34 patients before, during, and after the procedure using two schedules. Cultures were obtained once during the procedure in the first schedule and four times in the second. None of the cultures were positive by the first schedule, while 23% of patients studied by the second schedule had one or more positive cultures. Organisms isolated were anaerobes. The bacteremia was transient and self-limited, without serious clinical sequelae. The incidence of bacteremia during barium enema examination was statistically indistinguishable from bacteremia previously reported during colonscopy. It is concluded that antibiotic prophylaxis is not indicated in most patients undergoing colonic diagnostic procedures. Prophylaxis in selected high-risk patients requires further study.

Etiologic and therapeutic aspects of intussusception in childhood

Fifty-two instances of intussusception in fortynine patients treated at the Hadassah University Hospital during a fifteen year period were analyzed. Intussusception was reduced with no subsequent complications in 47 per cent of the children who underwent barium enema reductions. Recurrence of intussusception occurred in 6 per cent, all of them successfully reduced again by barium enema. Sixty-five per cent of the patients underwent operation, of whom seven had pathologic lead points (lymphosarcoma, Meckel's diverticulum, leiomyoma, and intestinal polyp). Our experience and the collected evidence in the literature indicate the importance and usefulness of the barium enema examination as an excellent diagnostic and therapeutic modality in intussusception. Only when incomplete or uncertain reduction occurs should operative intervention be undertaken. The only contraindication to barium enema should be very marked intestinal obstruction or peritonitis. Regarding the etiology of idiopathic intussusception, we believe that hypertrophy of the lymphatic tissue in the terminal ileum, reactive to some common diseases of infancy and childhood, is a major causative factor.

Proceedings: Carcinoembryonic antigen. Report of a screening study.

Originally described as a specific marker for colonic carcinomas, carcinoembryonic antigen (CEA) has recently been demonstrated in elevated titers in patients with a variety of non-neoplastic diseases, especially in patients with serious metabolic disorders and in patients with inflammatory bowel disease. We are reporting results of CEA screening in 576 patients undergoing barium enema examination. None were known to have cancer, previously diagnosed or recurrent. Of this group, 23 were discovered to have primary or recurrent colonic cancers. CEA-radioimmunoassays by the Zirconyl phosphate gel method of Hansen were positive (>2.5 ng/cc) in 18 and greater than 5 ng cc in 15. However, in 4 of 13 early stage colonic carcinomas, CEA values were normal. Of the remaining 553 patients, none had proven cancer. Ninety-eight (18%) of them had elevated CEA values, but only 18 of these were greater than 5 ng/cc. Forty-six of these CEA positive patients had acute inflammatory bowel disease, acute gastrointestinal disorders, collagen diseases, or serious chronic metabolic diseases. Repeat CEA sampling in a third of the “false” positive group produced normal results in most. To date only 1 of the 98 “false” positive group is known to have developed a diagnosable cancer within the year. Of the CEA negative group, none have reported development of cancer. Caution is advised against interpreting a single elevated CEA value as synonymous with colonic cancer, and against dismissing the possibility of early colonic cancer in the face of a normal CEA value.

ECG Abnormalities Associated With the Barium Enema

Electrocardiographic monitoring of 95 patients who underwent barium enema examination (BE) revealed that ECG changes are common (46%) during the procedure and tend to occur more frequently in the elderly and in persons with heart disease. Over a third of the changes were judged "potentially serious." None of the subjects died or developed definite myocardial damage directly attributable to the BE. In one patient ischemic changes appeared on the 12-lead ECG 48 hours after the BE but were of uncertain significance and relation to the procedure. No elevations in serum enzyme (creatine phosphokinase and a hydroxybutyric dehydrogenase levels could be attributed to the BE. The use of a balloon-tipped enema catheter was associated with a greater, but not statistically significant, frequency of BE ECG abnormalities.

ECG abnormalities associated with the barium enema

Electrocardiographic monitoring of 95 patients who underwent barium enema examination (BE) revealed that ECG changes are common (46%) during the procedure and tend to occur more frequently in the elderly and in persons with heart disease. Over a third of the changes were judged "potentially serious." None of the subjects died or developed definite myocardial damage directly attributable to the BE. In one patient ischemic changes appeared on the 12-lead ECG 48 hours after the BE but were of uncertain significance and relation to the procedure. No elevations in serum enzyme (creatine phosphokinase and a hydroxybutyric dehydrogenase levels could be attributed to the BE. The use of a balloon-tipped enema catheter was associated with a greater, but not statistically significant, frequency of BE ECG abnormalities.