Barium Enema Flashcards
- a radiographic examination of the colon or the large intestine with the use of contrast media.
- requires the use of contrast media to demonstrate the large intestine and its component.
Barium Enema
What is the purpose of the Barium enema?
Radiographically study the form and function of the large intestine to detect any abnormal conditions
What kind of contrast media are used?
- Barium Sulfate (most common type of postive CM)
- Room air, nitrogen, and carbon dioxide (most common type of negative CM)
- Iodinated, water-soluble contrast medium
What are the advantages of barium sulfate?
- The main advantage of barium over water soluble contrast agents is better coating resulting in better mucosal detail.
- Low cost.
What are the disadvantages of Barium Sulfate?
- High Morbidity associated with barium entering the peritoneal cavity.
What are the common clinical indications?
- To demonstrate colitis
- To demonstrate Ulcerative Colitis
- To demonstrate diverticula
- To demonstrate polyp or tumor
is produced by barium coating both the body of the polyp (arrow) and the recesses (arrowheads) between the base of the lesion and the normal colonic
mucosa.
Bowler Hat Sign
What are the contraindications?
- possible perforated hollow viscus
- a possible large bowel obstruction
- Appendicitis
- Recent barium meal. It is advised to wait for 7–10 days.
- Incomplete bowel preparation.
- Patient frailty.
is recognizable by the multiple, small bubbles of gas present within a
semi solid appearing soft tissue density (white circle).
Stool
What are the types of Examination?
- The single contrast study
- The double contrast study
- a procedure in which
only positive-contrast media are sed - in most cases, the contrast material is barium sulfate in a thin mixture - occasionally, the contrast media must be a water-soluble
contrast material
The single contrast study
- a second common type of barium enema procedure - more
effective in demonstrating polyps and diverticula than singlec ontrast
studies - both air and barium must be introduced into the large bowel
- much thicker barium mixture is required. Although exact
ratios depend on the commercial preparations used, the ratio approaches a 1:1 mix, so that the final product is like heavy
cream
The double contrast study
the Radiologist instill barium and air during a single filling procedure
Single Stage-Procedure
Barium is partially or completely evacuated before air is instilled
Two-Stage Procedure
a functional study of the anus and rectum that is conducted during the evacuation and rest phases of defecation (bowel movement)
Evacuative Proctography (defecogram)
What are the patient’s preparation?
- Cleansing enema at 3:30 p.m. (1 day before the examination) until return flow is clear.
- Light supper should be given.
- Give laxative to patient either dulcolax tablet or castor oil.
What are the purpose of giving laxative/dulcolax/castor oil?
- to soften the feces
- to reduce friction between the feces and the intestinal wall
- to facilitate evacuation
- NPO at midnight (not even water or candy)
- Another shot of cleansing enema at 5:00 a.m. the next
morning. - No breakfast and proceed to x-ray department.
- can be made of stainless
steel or other material accentuates the flow of
the compressed air instead of gravity
Enema can
- must have a capacity of about 2-3 quarts so that emptying of the can will be avoided which can draw air into the rectum
Enema Can
- to allow for full distention of the colon, it must be placed 18- 24 inches above the level of the rectum
Enema Can
- made of rubber but more preferably disposable plastic
Tubing
- should be about 5-6 feet in length and ½ inch in diameter
Tubing
- interrupts the flow of barium once the colon is full
Stop cock or Clamp
What are the three common enema tip?
- Plastic disposable
- Rectal retention
- Air-contrast retention
- consists of a double-lumen tube with thin rubber balloon at the distal end
Rectal retention
- a special type of rectal tip needed to inject air through a separate tube into the colon. The air mixes with the barium to produce a double-contrast barium enema examination.
Air-contrast retention
-used to keep the enema tip in its place
Inflating bulb or Inflator
- has an air capacity of 90 cc
Inflating bulb or Inflator
- one complete squeeze of the inflator provides adequate distention of the retention balloon without any danger of over inflation
Inflating bulb or Inflator
- slippery substance that helps the enema tip without discomfort to the patient
KY Jelly
- used to administer barium sulfate or an air and barium
sulfate combination during the barium enema - This closed type, disposable barium enema bag system has replaced the older open-type system for convenience and for reducing the risk of cross-infection
Closed-system Enema container
- a functional study of the anus and rectum that is conducted during the evacuation and rest phases of defecation (bowel movement).
Evacuative Proctography (Defecography)
- a forward out-pouching of the anterior rectal wall which occurs during defecation or straining
Rectoceles
- small bowel prolaps
- occur when the small bowel descends into lower pelvic cavity and starts pushing on the top portion of the vagina
Enteroceles
- an abnormal condition in which the proximal rectal wall invaginates into the distal rectum during defecation and persists after the bolus has passed.
Rectal Instussussception
- protrusion of rectal tissue through the anus to the exterior of the body.
Rectal prolapse
- for enema are mixed to obtain a toothpaste-like contrast medium that can be injected into the rectum
Hydrogel and Barium Sulfate
