Barium enema
Barium enema Sigmoidoscopy before a barium enema remains good practice, but not essential Bowel preparation: Browns dietary restriction, overhydration, and osmotic purgation Double contrast barium enema (DCBE) 3 stages 1. Filling with barium a. IV smooth muscle relexant – 20mg Buscopan or 0.5 – 1mg of glucagon b. Barium introduced while patient is prone until the barium column enters the transverse colon 2. Gas insufflation a. Ideally CO 2 b. Bring the patient into the head up position and drain the barium c. Rotate the patient to the right side – to open the hepatic flexure- the hepatic flexure is dependent and fills with barium d. The head of the table is then tilted to trap the barium in the ascending colon, and the patient is prone to fill the dependent cecum 3. Radiography Interpretation: 1. Surface pattern recognition : Barium interacts with the mucosa to form a 0.2mm coating adherent to the mucosa – thickness is usual