To further evaluate neonates with a distal bowel obstruction, a contrast enema
should be performed.
Diagnostic accuracy of double contrast enema
and rectosigmoidoscopy in connection with faecal occult blood testing of rectosigmoid neoplasms.
Before contrast enema
study, plain X-ray abdomen was taken in supine and erect postures.
A contrast enema
was requested to confirm the diagnosis.
x-ray, cystography, and ultrasound have some utility, particularly if CT scanning is not available.
Definitive diagnosis is accomplished by a barium or air contrast enema
. When intussusception is found, the test becomes therapeutic.
An air contrast enema
is advocated as the preferred method by many pediatric surgeons, but since there is no clear consensus among radiologists of the best contrast enema
option, this decision is best left to the pediatric surgeons performing the contrast enema
In fact, in one large review with abdominal radiographs alone, cecal volvulus was suggested in 46% of patients, but diagnostic in only 17%.4 If the positive diagnosis is not made on the abdominal series, follow-up films, contrast enema
, or CT exam is required.
The small bowel also can be filled with a barium suspension injected through an ileostomy, colostomy or via the rectum after a single contrast enema
. These examinations can be used to study the entire small bowel, but generally are reserved for cases in which an obstruction in the distal intestine is suspected.
This is more difficult to see with an air contrast enema
compared to a barium or water-soluble contrast enema
or multiplanar CT can reveal a beak-like configuration defining the point of obstruction.