Direct invasion of the transverse colon by a cecal tumor

Direct invasion of the transverse colon is known to result from noncontiguous primary tumors spreading along ligamentous attachments or from direct extension of metastatic disease involving the greater omentum. The resultant desmoplastic reaction produces characteristic findings on barium enema. However, to our knowledge, these findings have not been reported to result from extension of a cecal tumor to the transverse colon via the pericolonic fat. We present such a case and discuss the radiographic findings.     

钡灌肠与排粪造影对功能性便秘的X线诊断

目的探讨钡剂灌肠与排粪造影在功能性便秘诊断中的作用。方法对260例临床诊断为功能性便秘的患者,采用钡剂灌肠与排粪造影同时检查的方法进行检查对比。结果260例便秘患者中,钡剂灌肠有异常179例,其中乙状结肠延长、迂曲119例;横结肠下垂69例。排粪造影有异常217例,其中直肠前突174例;直肠黏膜脱垂73例,耻骨直肠肌综合征87例,盆底肌痉挛综合症73例;较多患者两者检查均有异常。结论对功能性便秘的患者,应用钡剂灌肠与排粪造影同时检查,能更好了解结肠全貌,为临床治疗提供更可靠的诊断依据。     

Pneumoperitoneum occurring during double-contrast enema

A case of pneumoperitoneum occurring during double-contrast barium enema is described. Cases reported to date indicate that colonic rupture during a double-contrast enema is likely to result in exit of air rather than barium from the colon. The diagnostic implications of this observation are considered. The potentially high pressure generated by bulb-type inflators is discussed, and caution is advised against overdistending the colon during double-contrast enemas.     

结肠冗长症误诊肠梗阻15例分析

目的 分析结肠冗长症的诊断、鉴别诊断、并发症及手术治疗。方法 收集1990～2002年间误诊为肠梗阻的结肠冗长症15例进行回顾性分析和总结。结果 主要依靠钡剂灌肠X线检查诊断。全结肠型8例，乙状结肠型3例，横结肠型4例，合并有急性乙状结肠扭转1例，结肠黑便病2例。外科治疗分别为右半结肠切除术8例，横结肠切除术4例，左半结肠切除术1例，Hartmann氏手术2例。结论 临床症状和钡剂灌肠X线检查是鉴别诊断结肠冗长症的主要方法，手术是治疗结肠冗长症、预防并发症的有效方法。     

Amyloidosis of the colon presenting as ischemic colitis: A case report and review of the literature

Review of the English literature revealed 21 cases describing abnormalities on barium enema secondary to amyloidosis of the colon. These cases were categorized as to frequency of specific barium enema findings and distribution within the colon. The most common radiologic findings were luminal narrowing (11 of 21), loss of haustrations (10 of 21), thickened mucosal folds (8 of 21), mucosal nodularity (8 of 21), and ulceration (6 of 21). The most frequent locations of disease within the colon were the descending and rectosigmoid portions (13 of 21). We present a case of primary amyloidosis that demonstrates the findings of bowel wall thickening and luminal narrowing on doublecontrast barium enema and computed tomography (CT). Pathologic examination in our case, in addition to similar observations from the literature, suggests that at least a part of the radiologic changes of colonic amyloid can be attributed to bowel ischemia.     

Thermal injury of the colon due to colostomy irrigation

A case of thermal burn and stricture of the colon following colostomy irrigation with hot water is described. The initial radiographic features on barium enema simulated nonspecific segmental colitis. Colonic stricture and enterolith formation developed subsequently. This case emphasizes that care should be taken in preparing irrigating and barium enema solutions.     

64层螺旋CT成像技术在结肠癌诊断中的价值

目的比较64层螺旋CT(MSCT)结肠成像与电子结肠镜、钡灌肠在结肠癌中的应用,探讨64层MSCT成像技术对结肠癌的诊断价值.方法将56例结肠癌病人结肠充气后进行64层MSCT扫描,扫描获得的原始图像利用工作站进行VR、CTVE、SSD及MPR-CTVE融合图像等图像重建.56例同时行钡灌肠检查,36例同时行电子结肠镜检查.将重建的VR图像、SSD图像与钡灌肠检查结果进行观察并对其评分;同时将重建的CTVE图像、MPR-CTVE融合图像与电子结肠镜结果进行对照研究,观察其在结肠癌诊断中的准确性.结果 64层MSCT对所有病人的诊断符合率为100%,钡灌肠的诊断准确率为73.21%(41/56),电子结肠镜的诊断准确率为83.33%(30/36).结论 64层MSCT成像技术在结肠癌的诊断中具有独特的优越性,可作为结肠癌的首选检查方法.     

Oral administration of Amipaque in obstruction of the colon

Nine adult patients with complete obstruction of the colon on barium enema examination were evaluated after oral administration of Amipaque. This water-soluble iodinated contrast material proved useful in the diagnosis of obstructive lesion, outlining the narrowed segment and the more proximal colon. There were no side effects.     

Cystic lymphangioma of the transverse colon: report of a case and review of the literature

A 32-year-old Chinese man with cystic lymphangioma of the transverse colon is described. He presented with a 1-year history of altered bowel habits. Double-contrast barium enema study demonstrated a submucosal lesion in the midportion of the transverse colon with intact mucosa. Computed tomography (CT) showed a round 3.0-cm submucosal cystic mass lesion. Colonoscopy revealed a smooth, soft polypoid mass on a broad base. He underwent segmental resection of the colon. Histologically, the lesion was characterized by cystic lymphangioma originating from the submucosa. The clinical features, radiology, appropriate treatment, and possible pathogenesis of colonic lymphangioma are discussed. Received: 21 April 1995/Accepted: 23 May 1995     

Interval between cleansing enema and barium examination of the colon

A prospective, randomized, blinded study was conducted to determine the optimal length of time a patient should wait after evacuating a cleansing enema prior to undergoing barium enema. Evaluation of overhead films, graded for the amount of retained fluid and fecal material, detected no significant improvement in colon examinations that were delayed longer than 30 min. Patient acceptance and scheduling can be improved by eliminating unnecessary waiting.     

Retroperitoneal abscess: A presentation of colon carcinoma

Retroperitoneal abscess as an initial manifestation of carcinoma of the colon is unusual. Inappropriate management of an unrecognized lesion is invariably fatal. Awareness of this uncommon presentation can lead to a precise preoperative diagnosis and appropriate therapy. The possibility of a perforated colon carcinoma should be considered in instances of unexplained retroperitoneal mass and infection, and a barium enema performed on all such patients. The authors report 3 cases and illustrate the radiological features of retroperitoneal abscesses due to perforated colon carcinoma.     

Colitis in Behçet's disease: Characteristics on double-contrast barium enema examination in 20 patients

We performed a retrospective review of double-contrast barium enema examinations of 20 patients with clinically proven Behçet's colitis. Main lesion was ovoid or geographic ulcers with a mean diameter of 2.7 cm. The number of ulcers was single in 15 cases and multiple in five. On six resected specimens, ulcers involved submucosa in three, muscle layer in one, and serosa in two cases with an undermining tendency and transmural inflammation. Aphthous ulcers were present in three cases. Neither perforation nor fistula was demonstrated. In all 20 patients, the ulcer was localized in the ileocecal area, with extension to the ascending colon in seven. Skip lesions were observed in the transverse colon and descending colon in three cases. Destruction of surrounding mucosa resulted in cecal contraction in 19 cases, widening of the ileocecal valve in 19, and fold thickening in the terminal ileum in 12. Six cases (30%) manifested as ileocecal mass accompanied by ulcer, fold thickening, and adjacent mucosal deformity. The appendix was visualized in only three (20%) of the 15 patients with no history of appendectomy. On follow-up study of 15 cases, the ulcers disappeared or decreased in size in 13 cases (86%) and the mucosal deformity was not improved in all cases. On the basis of our results, we believe that the characteristic findings of colitis in Behçet's disease in barium enema examination are ovoid or geographic, relatively large, and deep ulcerations with persistent surrounding deformity which tend to localize in the ileocecal area.     

Sigmoid colon fistula complicating ovarian cystadenocarcinoma: A rare finding

A case of sigmoid colon fistula complicating ovarian cystadenocarcinoma is reported. The entity demonstrated a large air-filled, thin-walled cystic lesion during barium enema examination. The differential diagnosis of distended air-filled cystic lesions is discussed and expanded to include colonic fistula complicating ovarian neoplasms.     

Transverse colon volvulus: diagnosis and treatment

Although considered rare, transverse colon volvulus (TCV) may actually comprise as many as 10% of all cases of colon volvulus. Correct identification clinically is necessary in order to reduce the high mortality. Unlike the treatment of sigmoid volvulus, conservative treatment of TCV is thought to be inadequate. Furthermore, simple proximal colostomy may lead to bowel necrosis. Bowel resection, rather than detorsion procedures, is advocated. The barium or diatrizoate enema examination can readily differentiate TCV from sigmoid and cecal volvulus if one pays careful attention to detail.     

Pneumatosis coli: Is there a relationship with sigmoid colon redundancy?

Pneumatosis coli (PC) is a process characterized by gas-filled cysts in the wall of the large intestine. The barium enema examinations of 14 patients with idiopathic PC were assessed: 93% involved the sigmoid colon, and 84% of patients with sigmoid pneumatosis had sigmoid colon redundancy in comparison to 14% of the control population (p<0.001). It is proposed that the sigmoid cysts result in redundancy by affecting the mesentery and colon length. This redundancy may account for the increased risk of sigmoid volvulus in this condition.     

The extent of successful colonoscopy: Its implication for the radiologist

Records of 230 colonoscopies were reviewed to determine the success in viewing the entire colon and the extent of the colon viewed when colonoscopy was incomplete. It was found that colonoscopy was complete to the cecum or ileum in 57% of studies, and that an average 63.8% of the colon was viewed during incomplete studies. Overall, 84.4% of the combined length of all colons examined was successfully viewed. The significant numbers of incomplete colonoscopies suggest that colonoscopy and the barium enema examination must remain complementary for maximum detection of colon lesions.     

Water as contrast medium for computed tomography study of colonic wall lesions

A tap water enema combined with intravenous iodine contrast medium was used for computed tomographic (CT) study of the entire clean colon in 35 patients. Thirty of them showed a high suspicion of rectal, colon, or cecal pathology at either clinical examination, barium enema study, or endoscopy. The remaining five patients were examined for suspected local recurrence of carcinoma. This CT technique detected the wall abnormality in all but one case with two small adenomatous polyps. This procedure, which is simple, inexpensive, and has a good acceptance and tolerance, can accurately detect mural wall abnormalities.     

Radiographic and endoscopic findings in penicillin-related non-pseudomembranous colitis

The characteristic findings of barium enema and colonofiberscopic studies and their changes over time were investigated in 10 patients with penicillin-related non-pseudomembranous colitis. Radiographic examination within 6 days of onset revealed abnormal findings such as narrowing of the lumen, loss of haustral markings, thumb-printing, transverse ridging, and saw-toothed irregularities. These findings tended to be more pronounced on the right than on the left side of the colon. Endoscopy revealed lesions characterized by mucosal reddening, edema, and hemorrhage, without definite ulceration or erosion. In 5 of the 10 patients, non-continuous distribution of the lesions was noted. In 4 patients, the rectum was unaffected. Reversion to normal occurred within an average of 15.7 days following onset of the symptoms. Thus, for an accurate diagnosis of this disease, barium enema and/or total colonoscopy should be performed within 6 days of onset.     

The “air enema” in acute colitis

The plain abdominal radiograph is an important investigation in acute colitis, but may fail to demonstrate the state of the colon owing to a lack of intracolonic gas. The extent of the colitis can be demonstrated by introducing air directly into the large bowel; the air also provides sufficient contrast to distinguish a granular from an ulcerated mucosa. The air enema may be used as an alternative to an unprepared barium enema. Its accuracy has been established by comparison with an unprepared barium enema in 10 patients with acute colitis.     

钡灌肠联合消化道钡餐在先天性巨结肠等疾病中诊断价值

目的探讨钡灌肠联合消化道钡餐及钡滞留x线片在先天性巨结肠及其同源病中的诊断价值。方法回顾性分析30例先天性巨结肠或巨结肠同源病患儿的消化道钡餐、钡灌肠及钡滞留X线片影像资料。结果30例患儿中先天性巨结肠19例,先天性巨结肠同源病11例;钡灌肠显示,先天性巨结肠同源病组较先天性巨结肠组患儿狭窄段发生率少,直肠扩张发生率高,2组比较差异有统计学意义（P〈0．05）;消化道钡餐检查结果显示,病变部位钡剂传输时间明显延长。结论消化道钡餐联合钡灌肠及钡滞留X线片检查对先天性巨结肠及其同源病诊断有重要价值。