Air-contrast barium enema studies after flexible proctosigmoidoscopy: randomized controlled clinical trial.

Abstract

The authors performed a randomized clinical trial to determine the effect of flexible proctosigmoidoscopy (FPS) on the quality of air-contrast barium enema (ACBE) studies performed on the same day and whether it mattered if air or carbon dioxide was used for endoscopic insufflation. One hundred twenty-one patients were randomly assigned to one of the following groups: Same-day studies were performed, with air used for insufflation, in group 1; same-day studies, with carbon dioxide, in group 2; and separate-day studies in group 3. Scout images obtained before the ACBE study were graded for the amount of air seen, and ACBE studies were graded for overall quality; each was graded on a scale of 0-3 in a blinded fashion. The air score was significantly greater in group 1 (2.69) than in group 2 (2.01) (P less than .001), which in turn was significantly greater than in group 3 (1.53) (P less than .01). The ACBE quality scores in the three groups were not significantly different. The authors conclude that FPS can be done before ACBE examination without impairing the quality of the ACBE study. Although carbon dioxide insufflation results in less intestinal air after FPS, the quality of the ACBE study is not affected.

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

“…Eckhardt et al [12], using carbon dioxide for insufflation at FS, demonstrated that same-day FS and DCBE were feasible without impairing the quality of the DCBE. Marshall et al [14] found that it did not matter n = 78* *2 further ileorectal whether carbon dioxide or air was used for FS insufflation. On the other hand, Rodney et al [15] cancelled about one third of patients scheduled for same-day DCBE after FS, due to excessive bowel gas seen on a plain abdominal radiograph.…”

“…Previous authors have reported success in performing FS and DCBE as a one-stage procedure with a single bowel preparation [9,10,[12][13][14]. We have instigated a combined FS/DCBE service within our radiology department and report here our initial experience in our first 80 patients.…”

An Old Lady with Pencil-Thin Stool

“…Radiologists often complain about residual air in the colon after failed colonoscopy or sigmoidoscopy prior to air-contrast barium enema (ACBE). However, the feasibility of same-day flexible sigmoidoscopy and ACBE is well established [5], and we have shown in a controlled trial that patients who had failed colonoscopies had ACBEs of equal quality regardless of whether the ACBE was performed on the same day or another day [6].…”