The Barium Enema: A Reassessment Looking Toward Perfection

Peterson, Gary H.; Miller, Roscoe E.

doi:10.1148/128.2.315

Cited by 13 publications

(3 citation statements)

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“…So, too, might colonic distension associated with constipation. However, as a counter to this theory, there are no reports of spinall nerve root discomfort during enema procedures (Peterson and Miller, 1978;Bartram, 1986) when such a posteriomedially situated colon might exert pressure on ventral rami. Moreover, there are few reports of involvement of ventral rami by colonic neoplasms.…”

Section: Discussionmentioning

confidence: 99%

Posteriorly situated retroperitoneal colon: A study using CT and MRI

et al. 1993

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In a patient with symptoms attributable to lumbar spine disease, computed tomography (CT) demonstrated the descending colon lying in an exceptionally posteromedial position. The colon, within the retroperitoneal fat, passed between the psoas major and quadratus lumborum muscles, thereby abutting the normal left L4 ventral ramus lateral to the L5 pedicle. Although it remains debatable whether this curious anatomical arrangement was responsible for this patient's symptoms, the case prompted us to see how often the colon was situated so posteromedially. Among 33 consecutive patients whose abdominal CT images were analyzed, this close anatomical relationship was seen in only one patient; it was not seen in any of 50 randomly selected patients undergoing magnetic resonance imaging (MRI) of the lumbar spine. As judged by CT measurements, the average position of the most posteromedial portion of the descending colon lies 5 mm anterolateral to a plane joining the anterolateral margins of the psoas major, quadratus lumborum, and iliacus muscles and 54 mm from the ventral ramus. 0 1993 Wiley-Liss, Inc.

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Section: Discussionmentioning

confidence: 99%

Posteriorly situated retroperitoneal colon: A study using CT and MRI

et al. 1993

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“…The DCBE technique was usually similar to that described by Peterson and Miller [11]. Intravenous Buscopan (Boehringer Ingelheim (NZ) Ltd., Auckland, New Zealand) at 20 mg was usually administered.…”

Section: Methodsmentioning

confidence: 99%

Colonoscopically detected colorectal cancer missed on barium enema

Anderson

Cook

Coates

1991

Gastrointest Radiol

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The radiographs and clinical records of 26 patients with colorectal cancer missed on barium enema, and subsequently detected at colonoscopy, were reviewed to determine the cause of radiological error. Twenty (77%) of the patients were female. In 24 of 26 patients, anemia and/or rectal bleeding was a presenting feature. Fourteen of the 26 (54%) missed cancers were in the sigmoid colon, 10 (38%) in the ascending colon or hepatic flexure, and two (8%) in the rectum. Tumor size ranged from 20-100 mm. Fifteen were polyps, and 11 annular cancers. Fourteen (54%) were Dukes C or D tumors. Twenty-eight barium enemas in 23 patients were available for review: 86% were double-contrast studies. In 18 (76%), the cancer could be seen in retrospect and, in over half, the tumor was obvious. The dominant perceptive error was due to missing the lesion in the barium pool. Other major errors were missing the lesion en face or in overlapping loops. As most cancers were missed because of observer perceptive error, by both experienced and inexperienced radiologists, the authors recommend double reporting of all barium enemas.

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“…Early proponents of the DCBE recommended that a large number of overhead projections be obtained routinely during DCBE [7,8]. Recently, studies have analyzed the efficacy of the different views and have indicated those with the highest yield of diagnostic information [9,10].…”

Section: Introductionmentioning

confidence: 99%

Limiting overhead views in double-contrast colon examinations does not affect diagnostic accuracy

Feczko

Halpert

1987

Gastrointest Radiol

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A prospective study was undertaken to evaluate whether reducing overhead (technician-performed) films in double-contrast colon examinations had any effect on diagnostic accuracy. Only 4 overhead films were obtained routinely: supine, both decubitus, and prone cross-table rectal views. A high detect rate was maintained, comparable to our accuracy when 7 or 8 overhead films were obtained. Our study confirms that with double-contrast colon examinations, the need for overhead films is diminished. A significant decrease in cost, radiation exposure, and examination time can be obtained. We continued to use this method without any noticeable decrease in diagnostic accuracy.

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The Barium Enema: A Reassessment Looking Toward Perfection

Cited by 13 publications

References 0 publications

Posteriorly situated retroperitoneal colon: A study using CT and MRI

Posteriorly situated retroperitoneal colon: A study using CT and MRI

Colonoscopically detected colorectal cancer missed on barium enema

Limiting overhead views in double-contrast colon examinations does not affect diagnostic accuracy

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