Double Contrast Barium Enema

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed

Contrast:
None

Technique:
Left lateral - digital exam and insert tip and inflate balloon with 2 puffs and fluoroscopy to check position
LAO when barium enters descending colon
Stop barium when it is in distal 1/3 of transverse colon
Tip up 30 degrees and drain and then tip back down
Prone and inflate until air is in the splenic flexure
Prone/RAO mid sigmoid
Roll patient towards you to RPO
Inflate until barium runs over hepatic flexure
Turn to left lateral and inflate more
Deep LPO - rectosigmoid
Mid-shallow LPO - sigmoid
RPO - proximal sigmoid to distal descending
Supine and inflate and then tip up 70 degrees
RPO - splenic flexure
AP - transverse colon
LPO - hepatic flexure
Prone and tip down to 30 degrees and drain
Left lateral - lateral rectum
Supine and tip down
Drain cecum if needed
AP or slight oblique - cecum
Overheads - bilateral decub, AP and PA recumbent, Butterfly
Take out tip

Views to Take:
Not applicable

References:
See References Chapter.

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