Barium Enema or Lower Gastrointestinal Series
- Barium enema is introduced per anal canal and X-rays are taken to detect pathology in the rectum, sigmoid colon, descending colon, transverse colon, transverse colon and ascending colon.
- It must be remembered that when the patient is extremely ill, preliminary straight X-ray is required. If they show colonic dilatation (mega-colon), barium studies should be judged to be contraindicated.
- In early stage barium enema will fail to show any ulceration in chronic disease. The mucosal surface will appear smooth. But the colon becomes shortened and looses its haustral pattern.
- Later on, pseudo-polyps may be shown as multiple small filling defects.
- In acute disease mucosal ulceration may be shown. There will be ulceration and pseudo-polyposis.
- As the rectum is almost invariably involved in ulcerative colitis, the disease can be diagnosed with confidence by sigmoidoscopy and biopsy.
- In mild cases the mucosa becomes friable.
- In more severe conditions diffuse hemorrhagic inflammation becomes obvious.
- Ulcer exudates can be seen.
The deformities which are revealed by this examination in various pathologies of this region are-
- Ulcerative colitis
- Crohn’s disease
- Carcinoma of the colon
- Colon polyps
- Stricture of the colon
Barium Enema Complications
- Stricture
- Carcinoma
- Pseudo-polyposis
- Hemorrhage
- Ischio-rectal abscess
- Fistula-in-ano
- Arthritis
- Cirrhosis of liver
- Ankylosing spondylitis
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