Addition of methyl cellulose enema to double-contrast barium imaging of sigmoid diverticulosis.

UNLABELLED: Double-contrast barium enema has a reduced sensitivity in patients with severe sigmoid diverticulosis. Therefore a carboxy methyl cellulose enema was employed after the conventional double-contrast examination in 15 patients with sigmoid diverticulosis. A significant increase in lumen diameter and a superior removal of barium residue from the diverticula facilitated the interpretation of the sigmoid loops. CONCLUSION: The addition of methyl cellulose enema to double-contrast barium imaging improves diagnostic imaging in diverticulosis by expanding the lumen and emptying the diverticula.

Wheat fibre before radiography of the large bowel.

Constipation is today treated by adding non-absorbable fibres to a normal diet. The aim of this investigation was to study the influence of fibres on colon cleansing results in patients referred for double contrast examination of the colon. A series of 240 consecutive patients were separated into two groups, one treated with one day of starvation and the routine cleansing regimen, the other group with wheat fibres thrice daily for four days before the day of the regular cleansing program. No difference in cleanness between the two groups was seen.

Radiographic findings in overlooked colon carcinomas. A retrospective analysis.

Double contrast barium enemas in 21 patients with primarily overlooked colon carcinomas were reviewed. The carcinomas were flat and measured less than 30 mm in 18 cases. These tumours constitute almost 1.4 per cent of the carcinomas diagnosed during a 12-year period. The retrospective analysis revealed the following signs of carcinoma: missing haustral folds, disharmony of interhaustral fold patterns; radiolucent filling defects; local contractions; residue-like masses and decrease of volume. In all cases, at least two secondary signs of carcinoma, range 1.7 to 3, were seen.

Defecography.

Defecography is a technique of examining the rectum and anal canal in which the patient is studied while sitting down rather than recumbent and recordings are obtained both at rest and during straining. The authors describe their findings in 83 patients with dyschezia. Defecation was normal in 28 patients. Prolapse of the anal mucosa was seen in 13 patients and internal procidentia in 23, 12 of whom also had intussusception manifested as rectal prolapse. A deep rectogenital fossa associated with an enterocele was seen in 16 patients; 13 had a proctocele, while fecal retention was seen in 5. Descent of the pelvic floor and changes in the angle between the rectum and anal canal were assessed. The authors recommend defecography as a more physiological means of assessing rectal dysfunction.

Colon cleansing regimens. A clinical study in 1200 patients.

The purgative effect of bisacodyl, anthraquinone glycosides (Cascara), and sodium picosulfate, alone or in combination with a saline purge and a tap water enema, was studied in 1200 patients. The cleansing effect was scored with regard to retained fecal residue evident on double-contrast studies of the colon. The combination of a contact laxative and a saline purge produced good cleansing effect in 52%-80% of the patients. With an additional tap water enema given 1 hour before the colon examination, however, 96% of the colons were clean. The taste and the effects of the cleansing systems were tolerated favorably by more than 90% of the patients. However, 17% reported restriction in work capacity on the day of bowel cleansing.

Double contrast enema and colonoscopy in polyp detection.

The diagnostic accuracy of double contrast enema was assessed by colonoscopy of 250 consecutive patients with polypoid lesions that were observed at double contrast enema. The enema method detected 90% of all existing polypoid lesions, and gave false positive results in less than 3.5% Colonoscopy revealed 91% of the lesions. Double contrast enema is suitable as a screening procedure and, when used in combination with colonoscopy, only very few polyps will escape detection. The large number of neoplastic polyps detected in this retrospective series emphasises the necessity for a careful radiographic technique combined with colonoscopy to disclose and treat these potentially malignant lesions of the colon.

[The radiologic diagnosis of inguinal hernias. Experience with the use of intraperitoneal iodinated contrast media (author's transl)]. / Röntgenologische Leistenbruchdiagnostik -- Erfahrungen mit intraperitonealer Jodkontrastinstillation.

By injecting an iodine contrast medium into the abdominal cavity and by placing the patient in a position with the table somewhat elevated, it is easy to visualize the inguinal region. The examination is performed with the X-ray tube angulated caudally, and exposures are made while the patient is straining. The method is well adapted for patients with obscure pains in the groins, for patients operated for hernias but not cured of pain and for patients in whom symptoms recur postoperatively without clinical evidence of hernial relapse. The value of the methode appears from four short case reports.