DEFINITION

It is a radiological
study of large bowl
by adminstration of
contrast medium to
rectum.
 CONTRAST
• Barium Sulphate
– White cryatalline powder
– Atomic number - 56
– Insoluble in water
– Non toxic
• Disorders of esophagous, small and large
intestine checked
• X-RAYs and CTs seen more clearly
 PREPARATION
• Empty the colon- elimate fecal material from colon and rectum
• Patient should maitain special diet and fast for 6 hours before
procedure
• Drink plenty of water to prevent dehyration

WARNING: NOT TO BE DONE IN CASE OF-

 Diarrhoea
 Total obstruction
 Paralytic illius
 Children less than 8yrs of age
 POSITIONS TO BE USED
Parts of Bowel Views
Rectum/ Sacral Space Left lateral, prone
Rectosigmoidal/ Sigmoid Colon RAO/ LPO
Splenic Flexure Upright- RAO/ LAO
Hepatic Flexure Upright- RAO/ LAO
Entire Colon Supine
Caecum Supine
 SINGLE CONTRAST v/s DOUBLE
CONTRAST
• Low density Barium • High density Barium
suspension to promote see suspension (75-90% w/v)
through effect (15-20%
w/v)

• Without air insufflation • With air insufflation

 Indication for DCBE and SCBE

• High risk with patient- recta bleeding,carcinoma or

polyposis, colorectal cancer
• Reduction of intessusception
• Risk with fistula, diverticulosis
• Diarrhoea
• Presence of obstruction
 Contraindication for DCBE and SCBE
• Allergy to barium suspention

• Asthma, diabetes, pregnancy

• Peritonitis

• Acute or inflammatory colon disease

• Inability to co-operate,unconscious,debilitated

• History of colonic biopsy

• Incomplete bowel preparation

• Toxic megacolon
 PROCEDURE
• Scout flim is taken of the AP abdomen (15-20 min)
• Interavenous injection of buscopan/ glucagon(20 ml)
• Intermittent screening to check the barium
• Patient in prone postion
• Flexible rectal catheter is inserted with air in anus gently without injuring
rectum
• Barium is passed through the tube
• Air passed down the enema tube into the colon to coat barium along the
walls
• X-ray images taken with different positions
• Tube removed
 AFTER CARE

• Patient should be warned that their bowel motion

will be white for few days
• Laxatives should be used to avoid barium
impaction in patients with constipation
 ADVANTAGES OF ENEMA
• Better surface details seen
• Surface lesions demonstated to the best effect
• Possible to look through loops as colon unravels

DISADVANTAGE OF ENEMA
• Distention of the colon is uncomfortable
• Patient may be uncorporative
• Complication of peritonitis
• Constipation
• Polypoid lesion is possible