Value of double-contrast barium enema performed immediately after incomplete colonoscopy.
OBJECTIVE
The purpose of this study was to evaluate the ease, completeness, and clinical utility of double-contrast barium enema (DCBE) performed immediately after incomplete colonoscopy.


METHODS
During a 30-month period, a prospective study was performed in 103 patients (79 women, 24 men) to determine the ease and completeness of DCBE immediately after failed colonoscopy and any additional useful information provided by the enema. The ease with which DCBE was performed was graded from 1 (easy) to 10 (difficult).


RESULTS
DCBE revealed the entire colon in 97 patients (94%). Incomplete DCBE was a result of obstruction and incontinence in three patients each. The mean score for ease of performing DCBE was 5.0. In 14 patients (14%), significant additional diagnostic information was provided by the immediate DCBE. In eight patients, abnormalities were identified on DCBE that had not been seen at colonoscopy (five malignant neoplasms, one diverticular mass, two extrinsic masses, and multiple strictures). In four patients, a suspected colonoscopic abnormality was excluded with DCBE findings; and in two patients, a colonoscopic abnormality was further characterized with DCBE.


CONCLUSIONS
Immediate DCBE after incomplete colonoscopy allows complete colonic evaluation in most cases, often adds vital diagnostic information, and eliminates repeated bowel preparation and unnecessary delay in diagnosis.
Department of Radiology, McMaster University Medical Centre, 1200 Main St. W., Hamilton, Ontario L8N 3Z5, Canada.
A L
AL
Brown
S J
SJ
Skehan
T
T
Greaney
J
J
Rawlinson
S
S
Somers
G W
GW
Stevenson
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate; D003108:Colonic Diseases / Q000000981:diagnostic imaging*; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging*; D003113:Colonoscopy; D003287:Contrast Media; D003424:Crohn Disease / Q000000981:diagnostic imaging; D004239:Diverticulitis, Colonic / Q000000981:diagnostic imaging; D004733:Enema; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011859:Radiography
D003287:Contrast Media; D001466:Barium Sulfate