Barium enema2

Question 1

What concentration of barium suspension is used for a single contrast barium enema, and why?

Answer 1

• Low density barium suspension (15% to 20% w/v) is used to promote a see-through effect with high kV or compression.

Question 2

During a single contrast barium enema, what action should be taken if the enema tip becomes obstructed by soft fecal material?

Answer 2

Withdraw the rectal tube about 1 inch (2.5 cm).

Question 3

After the rectal ampulla fills during a single contrast barium enema, what is the next step?

Answer 3

The tube is clamped, and a lateral view is taken.

Question 4

After the lateral view of the rectum, in what position is the patient placed for the frontal view film of the rectum during a single contrast barium enema?

Answer 4

Prone What patient position is used to obtain a Right Postero-Anterior oblique view during a single contrast barium enema?.

Question 5

What patient position is used to obtain a Left Postero-Anterior oblique view, and what anatomical structure is best visualized?

Answer 5

Prone oblique with the left side down; the splenic flexure.

Question 6

What patient position is used to obtain spot films of the hepatic flexure during a single contrast barium enema?

Answer 6

Prone with the right side down oblique (Right Postero-Anterior oblique).

Question 7

When are ileocaecal spot films typically exposed during a single contrast barium enema?

Answer 7

As soon as reflux across the ileocaecal junction takes place.

Question 8

Describe the tube angulation and patient position for a pelvic outlet view of the rectum during a single contrast barium enema.

Answer 8

30° cranial angulation to the tube with the patient supine.

Question 9

Describe the tube angulation and patient position for a pelvic inlet view of the sigmoid colon during a single contrast barium enema, and when should this view be taken?

Answer 9

30° caudal tilt to the X-ray tube with the patient supine; before the transverse colon is filled with barium.

Question 10

What are the most commonly obtained projections for a single-contrast barium enema?

Answer 10

Postero-Anterior (PA) or Antero-Posterior (AP), Postero-Anterior obliques (RAO and LAO), axial for the sigmoid, and Lateral to show the rectum.

Question 11

What is the primary advantage of a double contrast barium enema compared to a single contrast study?

Answer 11

Better surface details and the ability to demonstrate surface lesions to the best effect.

Question 12

What is the crucial finding on a preliminary abdominal radiograph that would necessitate cancellation of a double contrast barium enema?

Answer 12

The presence of residual faecal matter.

Question 13

List six indications for a double contrast barium enema.

Answer 13

• Rectal bleeding
• Previous history of carcinoma or polyp
• Family history of colorectal cancer or polyposis
• Demonstration of sinuses or fistulas.
• Patient with severe diverticulosis, polyposis, or diarrhoea;
• Presence of obstruction
• Reduction of an intussusception.

Question 14

List five contraindications for a double contrast barium enema.

Answer 14

• Allergy to barium suspension
• Peritonitis
• Acute or fulminating inflammatory colon disease
• Debilitated, unconscious, or inability to cooperate
• History of recent rectal/colonic biopsy.