Value of double-contrast barium enema performed immediately after incomplete colonoscopy

OBJECTIVE. The purpose of this study was to evaluate the ease, completeness , and clinical utility of double-contrast barium enema (DCBE) performed imm ediately after incomplete colonoscopy. SUBJECTS AND METHODS, During a 30-month period, a prospective study was per formed in 103 patients (79 women, 24 men) to determine the ease and complet eness of DCBE immediately after failed colonoscopy and any additional usefu l information provided by the enema. The ease with which DCBE was performed was graded from 1 (easy) to 10 (difficult). RESULTS. DCBE revealed the entire colon in 97 patients (94%). Incomplete DC BE was a result of obstruction and incontinence in three patients each. The mean score for ease of performing DCBE was 5.0. In 14 patients (14%). sign ificant additional diagnostic information was provided by the immediate DCB E. In eight patients. abnormalities were identified on DCBE that had not be en seen at colonoscopy (five malignant neoplasms, one diverticular mass. tw o extrinsic masses. and multiple strictures). In four patients, a suspected colonoscopic abnormality was excluded with DCBE findings; and in two patie nts, a colonoscopic abnormality was further characterized with DCBE. CONCLUSION. Immediate DCBE after incomplete colonoscopy allows complete col onic evaluation in most casts, often adds vital diagnostic information, and eliminates repeated bowel preparation and unnecessary delay in diagnosis.