Do patients require outpatient follow-up after rapid referral double contrast barium enema?
BACKGROUND
In our hospital, patients above the age of 40 years referred with a change in bowel habit without rectal bleeding undergo a double contrast barium enema (DCBE) ideally within 2 weeks. Results of benign studies are sent to a consultant colorectal surgeon and a routine clinic visit arranged. The aim of this study was to identify whether, following DCBE, patients (i) presented at a later date with colorectal cancer and (ii) needed assessment in clinic.


METHODS
This is a review looking at all patients who underwent DCBE prior to routine clinic visit between January 2004 and December 2005. Hospital databases were cross-referenced to identify any patients presenting with a new diagnosis of colorectal malignancy between DCBE and April 2007. Clinic letters were reviewed to identify the number of outpatient visits prior to discharge and reasons for continued follow-up.


RESULTS
During the study period, 521 patients (age range 31-93 years, 316 female) had DCBE prior to assessment in clinic. Diagnoses: cancer 48 (9.2%), polyps 13 (2.5%), colitis 3 (0.6%), no significant pathology 457 (87.7%). Of this latter cohort, 387 (84.7%) were discharged after one clinic visit; 54 (11.9%) attended twice and 11 (2.4%) were seen more than twice. Reasons for multiple attendances were management of haemorrhoids/anal fissure or investigations of unrelated symptoms. No new cancers were identified in this cohort between January 2004 and April 2007.


CONCLUSIONS
Double contrast barium enema is a safe screening tool following a '2-week rule' referral with CIBH. Following a report of no significant pathology, there is no need to arrange routine follow-up.
Odofin
O
O
Department of General Surgery, Salisbury NHS Foundation Trust, Odstock, Salisbury, Wiltshire, UK.
Alexander
R
R
Bowers
H
H
Chave
H
H
Branagan
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017609:Barium Compounds; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000517:prevention & control; D004733:Enema; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D011859:Radiography; D012017:Referral and Consultation / Q000592:standards*; D006113:United Kingdom
D017609:Barium Compounds