A combined flexible sigmoidoscopy and double-contrast barium enema service: initial experience

Abstract

FS/DCBE is feasible as a one-stage combined procedure. The quality of DCBE following FS is satisfactory, and the extra yield of FS and its potential for biopsy make the combined FS/DCBE a useful technique in the investigation of large bowel disease.

Utility of flexible sigmoidoscopy as an adjunct to double-contrast barium enema examination

“…Nevertheless, there is controversy regarding the appropriate investigation of a symptomatic patient with suspected neoplastic disease in the large bowel [4][5][6]. Recently, a number of investigators have advocated the use of flexible sigmoidoscopy (FS) and double-contrast barium enema (DCBE) for such an indication [7][8][9][10][11][12][13], and this combination has been utilized at our hospital for 10 years.The aim of this study was to compare the accuracy of DCBE with FS in the detection of polyps and carcinomas in the sigmoid. In terms of cost constraint, we examined whether the addition of FS is accompanied by demonstration of additional clinically important information.…”

Imaging procedures in screening for colorectal cancer

“…Whether or not gastrointestinal radiologists, endoscopists, or nurses [31 ] should master sigmoidoscopy is a question for the local interdisciplinary organization. I do not think that the better diagnosis of diverticular disease with barium enema [27] is an argument weighty enough for our clinicians, i.e., to consider barium enema before colonoscopy if the~y have to choose. In fact, colonoscopy is the primary examination in almost all ongoing screening programs.…”

“…Because the distribution of colorectal lesions show preponderance for the left hemicolon, a combined procedure is suggested earlier [24][25][26] which is discussed in this issue of Abdominal Imaging [27], namely a limited endoscopic examination followed by a barium enema on the same day. This concept is based on sigmoidoscopy being less cumbersome to the patient and being rather easy to learn and perform while retaining therapeutic possibilities.…”

“…To avoid adding obstacles to the agreed-to result of screening trials by not perceiving depictable and curable lesions, double film reading by staff radiologists is mandatory. The combined procedure [27] is one way to increase the diagnostic sensitivity of the barium enema because small and sometimes malignant lesions always will be overlooked, not least in the area most frequently involved by neoplasias. Sigmoidoscopy is preferably done on the same day, as suggested by Mendelson et al [27].…”

“…The combined procedure [27] is one way to increase the diagnostic sensitivity of the barium enema because small and sometimes malignant lesions always will be overlooked, not least in the area most frequently involved by neoplasias. Sigmoidoscopy is preferably done on the same day, as suggested by Mendelson et al [27]. Whether or not gastrointestinal radiologists, endoscopists, or nurses [31 ] should master sigmoidoscopy is a question for the local interdisciplinary organization.…”