UTILITY OF FLEXIBLE SIGMOIDOSCOPY AS AN ADJUNCT TO DOUBLE-CONTRAST BARIUM ENEMA EXAMINATION

Background: There is controversy regarding the most appropriate invest igation for suspected colorectal carcinoma. We offered these patients same-day flexible sigmoidoscopy (FS) and double-contrast barium enema (DCBE). Methods: We reviewed the results of 117 consecutive adult pati ents. All patients underwent FS followed by DCBE on the same day, The radiographs were reviewed by two of the authors who were blinded to th e clinical information, flexible sigmoidoscopy reports, and the origin al DCBE report. Results: One hundred seventeen patients made up the st udy population. Thirty-four of the 117 patients had polyps and/or carc inoma. Three malignant tumours were detected by DCBE; one of these was also seen on FS, and the other two cancers were out of FS range, Fift y-three polyps were found by FS; nine were removed by biopsy prior to the enema examination. Of the 44 remaining polyps, DCBE failed to dete ct 87% of the 0-9-mm group and 67% of the >9-mm group. Ten polyps were seen only on DCBE; seven of these 10 were beyond the range of the sig moidoscope, and the three remaining polyps were less than 5 mm. Conclu sion: DCBE is insensitive in the detection of rectosigmoid polyps, FS should continue to be used as a complementary examination to DCBE in t he investigation of suspected colorectal carcinoma.