PEDIATRIC BARIUM ENEMA EXAMINATION - OPTIMIZING PATIENT SELECTION WITH UNIVARIATE AND MULTIVARIATE ANALYSES

We prospectively evaluated a total of nineteen symptoms, signs, and la boratory findings in 471 of 557 consecutive pediatric patients (from n ewborn to age 17) referred for barium enema examinations, to determine predictors of an abnormal study. A univariate analysis was performed, and a logistic regression model was developed. The most frequent indi cators for the barium enema examinations were abdominal pain (48 %), c onstipation (27 %) and tenderness (25 %). Twenty-two percent of the ex aminations were abnormal, and the most common diagnoses were intussusc eption (n = 22), appendicitis (n = 17), infectious colitis (n = 15), a nd Hirschsprung disease (n = 14). The indicators that were most helpfu l to predict a barium enema abnormality were abdominal mass, leukocyto sis, guaiac-positive stools, diarrhea, anemia, tenderness, and age les s than 1 year. If barium enema examinations were performed only when a t least one of the predictive indicators was present, 29 % of examinat ions would be eliminated, and 4.8 % of patients with detectable diseas e would be missed. The data indicate that identification of certain cl inical variables can provide an effective initial strategy for selecti ng patients to undergo barium enema examinations.