title: A combined flexible sigmoidoscopy and double-contrast barium enema service: initial experience.
abstract: BACKGROUND
  A service has been instituted offering a combined single-stage procedure of flexible sigmoidoscopy and double-contrast barium enema (FS/DCBE). The results have been reviewed in the first 80 patients to undergo this examination (45 male: 35 female; mean age 61.4 years).
  
  
  METHODS
  Indications for investigation were abdominal pain or suspected diverticular disease (22 patients), altered bowel habit (19), rectal bleeding (17), iron deficiency anemia (6), and miscellaneous (16). FS was followed immediately by DCBE. Radiographs were reviewed by two radiologists unaware of the FS findings.
  
  
  RESULTS
  The extent of FS was to the proximal sigmoid or sigmoid descending colon or splenic flexure in 12.5%, and mid or distal sigmoid in 37.5%. Biopsies were performed at FS in 26 patients (33%). In 67 (84%) of DCBEs the barium coating was assessed as satisfactory or better. FS yielded pathological findings not seen at DCBE in 21 patients (26%). DCBE demonstrated additional abnormalities within the range of the FS examination in 15 patients (19%), almost entirely due to its increased sensitivity for diverticular disease.
  
  
  CONCLUSIONS
  FS/DCBE is feasible as a one-stage combined procedure. The quality of DCBE following FS is satisfactory, and the extra yield of FS and its potential for biopsy make the combined FS/DCBE a useful technique in the investigation of large bowel disease.
authors.affiliation: Department of Radiology, Royal Perth Hospital, Western Australia.
authors.forename: R M
authors.initials: RM
authors.lastname: Mendelson
authors.forename: P J
authors.initials: PJ
authors.lastname: Kelsey
authors.forename: T
authors.initials: T
authors.lastname: Chakera
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018798:Anemia, Iron-Deficiency / Q000000981:diagnostic imaging; D001466:Barium Sulfate; D003109:Colonic Diseases, Functional / Q000000981:diagnostic imaging; D003111:Colonic Polyps / Q000000981:diagnostic imaging; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging*; D004239:Diverticulitis, Colonic / Q000000981:diagnostic imaging; D004733:Enema; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D011859:Radiography; D020694:Sigmoidoscopes
chemical_list: D001466:Barium Sulfate