title: Limitations of combined flexible sigmoidoscopy and double contrast barium enema in patients with rectal bleeding.
abstract: Eighty-seven outpatients with non-massive rectal bleeding or asymptomatic positive fecal occult blood were evaluated with 35 cm flexible sigmoidoscopy, double contrast barium enema (DBCE) and colonoscopy. 82% had hemorrhoids and 35% harbored colorectal neoplasia. The combination of flexible sigmoidoscopy and DCBE missed none of 7 malignant lesions. However, 36% of benign polyps greater than or equal to 1 cm and 60.25% of those less than 1 cm were not detected by this combination. The presence of hemorrhoids should not prevent a search for colon neoplasia and colonoscopy is the preferred method.
authors.affiliation: Department of Medicine, Tucson VA Medical Center Arizona Health Sciences Center.
authors.forename: L J
authors.initials: LJ
authors.lastname: Hixson
authors.forename: R E
authors.initials: RE
authors.lastname: Sampliner
authors.forename: M
authors.initials: M
authors.lastname: Chernin
authors.forename: J
authors.initials: J
authors.lastname: Amberg
authors.forename: F
authors.initials: F
authors.lastname: Kogan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D004733:Enema; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006484:Hemorrhoids / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D011859:Radiography; D012812:Sigmoidoscopy
chemical_list: D001466:Barium Sulfate