To evaluate the usefulness of barium enema examination for detection o
f small nonpolypoid adenomas, the barium enema study findings were rev
iewed in patients with flat or depressed adenomas of the colon 3-5 mm
in diameter that had been initially found during colonoscopy and that
had been diagnosed as adenomas at histologic analysis. Eleven of the 2
1 nonpolypoid adenomas were depicted on radiographs; they tended to be
located on the left side of the colon. The 10 other lesions were not
detected retrospectively on barium enema radiographs. The radiographic
findings in the depicted lesions included smooth, round, radiolucent
areas; in seven of these lesions, round or irregular barium flecks wer
e also seen. The radiolucent areas were attributed either to slightly
elevated growth of adenomas or to surrounding hyperplasia of nonneopla
stic glands; the central barium fleck seemed to conform to depressed a
reas within adenomas. Barium enema examination can demonstrate nonpoly
poid adenomas of the colon, even though colonoscopy seems superior to
barium enema examination for detection of these lesions.