Premium
The demise of the instant/unprepared contrast enema in large bowel obstruction
Author(s) -
Jacob S. E.,
Lee S. H.,
Hill J.
Publication year - 2008
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2007.01415.x
Subject(s) - medicine , perforation , radiology , bowel obstruction , supine position , barium enema , enema , radiological weapon , retrospective cohort study , surgery , colonoscopy , colorectal cancer , metallurgy , punching , materials science , cancer
Objective Imaging the colon in suspected acute large bowel obstruction (LBO) is traditionally carried out with a supine abdominal X‐ray (AXR) and erect chest X‐ray. If there is no clinical or radiological evidence to suggest a perforation, then an unprepared barium or water‐soluble contrast enema (CE) can be performed to confirm the presence of and demonstrate the site of obstruction. The advent of modern, fast multidetector CT (MDCT) scanners has changed management strategies for acute abdominal conditions including suspected LBO in all groups of patients especially the elderly, infirm and those on ITU/HDU. Method A retrospective case note analysis was carried over a 7‐year period in a single centre. The study criteria involved investigation of suspected LBO with CE, CT and MDCT. Results It showed a reduction in the number of contrast enemas performed. Conclusion MDCT was shown to be more accurate in the diagnosis of LBO, is usually available on a 24‐h basis, and in many institutions has replaced the urgent CE in this group of patients. This also has the advantage of excluding incidental findings and in staging malignant disease.