A COMBINED FLEXIBLE SIGMOIDOSCOPY AND DOUBLE-CONSTRAST BARIUM ENEMA SERVICE - INITIAL EXPERIENCE

Background: A service has been instituted offering a combined single-s tage procedure of flexible sigmoidoscopy and double-contrast barium en ema (FS/DCBE). The results have been reviewed in the first 80 patients to undergo this examination (45 male:35 female; mean age 61.4 years). Methods: Indications for investigation were abdominal pain or suspect ed diverticular disease (22 patients), altered bowel habit (19), recta l bleeding (17), iron deficiency anemia (6), and miscellaneous (16). F S was followed immediately by DCBE. Radiographs were reviewed by two r adiologists unaware of the FS findings. Results: The extent of FS was to the proximal sigmoid or sigmoid descending junction in 45% of patie nts, proximal descending colon or splenic flexure in 12.5%, and mid or distal sigmoid in 37.5%. Biopsies were performed at FS in 26 patients (33%). In 67 (84%) of DCBEs the barium coating was assessed as satisf actory or better. FS yielded pathological findings not seen at DCBE in 21 patients (26%). DCBE demonstrated additional abnormalities within the range of the FS examination in 15 patients (19%), almost entirely due to its increased sensitivity for diverticular disease. Conclusion: FS/DCBE is feasible as a one-stage combined procedure. The quality of DCBE following FS is satisfactory, and the extra yield of FS and its potential for biopsy make the combined FS/DCBE a useful technique in t he investigation of large bowel disease.