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Diagnostic Yield of Barium Enema Examination after Incomplete Colonoscopy¹

¹ From the Departments of Radiology (A.C., M.S.L., S.E.R., I.L.) and Medicine (J.N.S., G.G.G., W.B.L., M.L.K.), Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104. Received April 9, 2001; revision requested May 29; revision received September 11; accepted October 10. Address correspondence to M.S.L. (e-mail: levine@oasis.rad.upenn.edu).

View larger version (108K): [in a new window]   Figure 1. Supine oblique spot radiograph from a double-contrast barium enema examination in a 70-year-old woman with diarrhea shows an annular lesion in the cecum with shelflike borders (arrows). This patient underwent incomplete colonoscopy to the level of the ascending colon because of a tortuous, redundant colon. At surgery, the lesion was found to be a poorly differentiated carcinoma of cecum.

View larger version (108K): [in a new window]   Figure 2. Right lateral decubitus overhead radiograph from a double-contrast barium enema examination in a 76-year-old woman with rectal bleeding shows a 2.5-cm lobulated polyp (arrows) in the proximal descending colon. This patient underwent incomplete colonoscopy to the level of the distal sigmoid colon because of a colonic stricture secondary to radiation. At surgery, the lesion was found to be a tubulovillous adenoma.

View larger version (114K): [in a new window]   Figure 3. Supine oblique spot radiograph from a double-contrast barium enema examination in an 18-year-old man with rectal carcinoma shows a 1.1-cm ring shadow (arrows) in the proximal ascending colon that was thought to represent a sessile polyp. This patient underwent incomplete colonoscopy to the level of the splenic flexure because of inadequate preparation. However, the lesion was not detected at repeat colonoscopy to the cecum, so it was considered to be a false-positive radiographic finding, presumably related to presence of adherent stool.