air enema

air enema

The administration of air per rectum, either therapeutically (e.g., to reduce into intussusception, especially in children) or diagnostically (in conjunction with a barium enema to create a so-called “double contrast” series of films, which allows assessment of the colonic mucosa for superficial lesions, such as polyps, adenomas and cancer).
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Routinely, in the pediatric population, an attempt is given to manual reduction with air enema.
there is an absence of pseudoreduction, as seen with fluoroscopic-guided procedures, and there is no fluctuation in the intracolonic pressure, as seen with an air enema.
Water-soluble contrast has been used and more recently air enema reduction has been introduced.
The authors favor the air enema for speed, decreased radiation dose, and cleanliness, reserving the contrast enema for children with a higher pretest probably of a pathologic lead point based on age (<1 month old or >4 years old).
Then either reduction with barium, hydrostatic (lactated Ringer's) or air enema, or surgery
Possible etiologies of perforation in Western countries implicate chronic steroid administration, NSAIDs, severe underlying illness, trauma, iatrogenic perforations from EGD, and air enemas in the radiologic reduction of intussusception.