Critical reevaluation of barium enema study

The colon is one of the organs, the entirety of which is examined best by roentgenology, and barium enema is used extensively for this purpose. It is however not always easy to secure films of satisfactory quality because of the difficulty of cleansing the colon thoroughly before examination. In spite of a rigorous preparation, often the remained fecal material and residual of castor oil impose perplexing problem. The present study has been undertaken to improve the conventional barium enema without employing any special device or medication other than those at hand. The clinical materials consisted of 50 cases each of conventional and refined barium enema study performed at the Department of Radiology St. Mary's Hospital, Catholic Medical College during the period of 7 months from January 1971, Methods are detailed in Table I. The results scored according to modified Murray's criteria, were compared each other and following conclusion were drawn. 1. It must be emphasized that thorough final wash-out enema should be performed by a well trained person at the Department of Radiology, and use of an antispasmodic agent is encouraged to relive abdominal discomfort during barium instillation, and further help differentiate functional from organic spasm. 2. Adding of 0.25 percent tannic acid to barium suspension rather than to cleansing-enema water is much more effective in enhancing mucosal coating and barium emptying. Double contrast study by the present method is as much effective as the Malmoe method in disclosing minute lesions of the colon. 3. Shift of the time of castor oil administration from 9 to 6 o'clock in the evening before examination did not results in any significantly earlier termination of rush