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Barium Enema , Barium swallows

 Barium Enema

       The large intestine can be examined by contrast enema which may be simple contrast when only barium sulphate is use . This is done mainly in bleeding per rectum , colitis , alnd suspected large bowel obstruction 
   

Patient preparation

          Patient preparation is extremely important before this procedure is performed . The colon must be completely empty of all its contents . Different methods are used in different departments to achieve this . The full cooperation of the patient is most essential for this examination . The patient should be instructed 
 • ( 1 ) to keep the anal sphincter tightly contracted over the enema to tube prevent leakage , 
 • ( 2 ) to relax the abdominal muscles , 
 • ( 3 ) to concentrate on deep oral         breathing . The patient should undress   completely and wear an open backed gown . The be available near the barium suite so that the patient especially sick ones do not have to walk far . 




Technique 

    A little barium ( 15 % w / V ) is run through the tube to ascertain that there are no blocks . The patient positioned on his side with knees flexed . The lubricated enema tip is introduced into the rectum carefully and may be taped in place with the help of leukoplast . The patient asked to turn over on his back and the barium suspension is allowed to run slowly under fluoroscopic control . The barium is encouraged to fill the large bowel , which is achieved by turning the patient initially left side down and then on the right side . The filming schedule is variable according the areas of interest . However , generally on AP and later , spot films of the entire colon are taken . Fill the caccum and ileocaecal junction . On completion of the fluoroscopy examination , a large 14 " x 17 " film exposed in the supine , AP position to show the entire colon in the filled phase . The patient is then asked to go to toilet and instructed to expel as much barium as possible.A post evacuation radiograph is then taken to assess the clinic mucosa .

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