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Detection of small lesions of the large bowel; barium enema versus double contrast.

Roentgen study with the so-called opaque barium enema with some modifications is superior to double contrast study as the primary means of demonstrating polyps in the colon as well as other lesions. The method described combines fluoroscopy, high kilovoltage radiography, fluoroscopically aimed "spot films" taken with compression, suction and evacuation studies. In this way unsuspected as well as suspected polyps can be demonstrated, particularly if attention is directed to the region where polyps are most likely to be found-namely, the distal third of the large bowel. Double contrast study is quite valuable as a supplement to the modified "single contrast" barium enema, but it has not been sufficiently perfected to replace the modified opaque barium enema as a primary procedure. In many instances a combination of methods will, of course, be required.

Barium↗

Barium reduction of intussusception in infancy.

Barium enema reduction was used as the initial routine treatment in 29 infants with intussusception. In 22 of them the intussusception was reduced by this means. In three of eight patients operated upon the intussusception was found to be reduced. Four of the remaining five patients had clinical or x-ray evidence of complications before reduction by barium enema was attempted.Twenty-one of the patients, all of whom were observed in private practice, were treated without admission to the hospital. After reduction, these patients were observed closely by the clinician. None of these patients showed clinical or x-ray signs of complications before reduction. Certain clinical and roentgen criteria must be satisfied before it can be concluded that reduction by barium enema is complete. If there are clinical signs of complications with x-ray evidence of small bowel obstruction, only a very cautious attempt at hydrostatic reduction should be made. As the time factor is generally a reliable clinical guide to reducibility, the late cases should be viewed with greater caution. Long duration of symptoms, however, is not per se a contraindication to an attempt at hydrostatic reduction.

Barium↗