A Survey of Double Contrast Barium Enemas at Bristol Royal Infirmary

Barium enemas are one of the most commonly requested radiological examinations. Here in Bristol the enemas are carried out in double contrast, which is becoming widely accepted as the standard examination of the colon (Thoeni and Margulis 1978). However there are several problems which have to be overcome if an optimal double contrast examination is to be obtained. The colon must be free of its contents if abnormalities are not to be obscured, although this is true of all bowel examinations (Laufer 1976). Good mucosal coating must be obtained if fine details are to be seen. The radiologist's technique must be competent so that all the colon is seen in double contrast, preferably in at least two projections. Finally the examination is of no value unless it is interpreted accurately. Five hundred barium enemas were reviewed to identify how faecal contamination, poor mucosal coating, inadequate radiological technique, and poor interpretation detracted from the accuracy of the examination.