CONTRAST ENEMA IN SMALL AND LARGE-BOWEL O BSTRUCTION

In 115 patients with clinical and radiological signs of small and/or l arge bowel obstruction the contrast enema of the colon was evaluated p rospectively to localize the site of occlusion in the colon. Contrast enema was performed in 76 patients with Gastrografin(R) and in 39 with barium. In 22 of 24 patients with large bowel obstruction, in 7 of 11 with combined small and large bowel obstruction, in 4 of 14 with smal l bowel obstruction and in 19 of 66 with partial obstruction the site of obstruction was indentified in the colon. In 107 of 115 patients th e site of intestinal obstruction in the colon was either confirmed or excluded (sensitivity 89,2 %, specificity 96,6 %). In 6 patients the c ontrast enema failed due to incontinence, missing cooperation or insuf ficient preparation. In two cases with coprostasis the occlusion was m issinterpreted as a carcinoma. Electrolytes and serum fluid concentrat ion before and after the enema were not significantly influenced using the different contrast media. Contrast enema is indicated in patients with intestinal obstruction of unknown site, malignancies, after radi ation therapy and recurrent partial obstruction.