Barium Enema
Learn about the indications, contraindications, preparation, equipment, procedure, aftercare, and potential complications of a barium enema, a diagnostic test used to evaluate conditions such as colonic strictures, diverticulitis, fistulas, and postoperative leaks. Proper preparation, administration, and follow-up care are essential for a successful outcome.
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Presentation Transcript
INDICATIONS The patient is unable to turn quickly/effectively When only the position and length of a stricture is required Evaluation for acute diverticulitis (and CT unavailable for whatever reason) Evaluating for a colonic fistula Evaluation for postoperative leak after colon surgery
CONTRAINDICATIONS If evaluation of the colonic mucosa is what is clinically desired, then a double contrast barium enema is preferred. If screening for colon cancer, then CT colonography is preferred. Water-soluble contrast should be used when evaluating for postoperative leak.
PREPARATION Explain the procedure to the patient Do colonic irrigation Take the ultrasonography and colonoscopy Check all the prescriptions of the patient
EQUIPMENT Rectal tube (e.g. Miller) for the administration of contrast tape is often useful to tape the tube to the patient and prevent it from backing out Enema bag and IV pole Barium sulfate Sterile water A water-soluble iodinated contrast agent Laxatives Warm water, air pump, pint measuring jar
PROCUDURE Barium is mixed with equal amount of water to the suspension used for barium meal The enema is set and is allowed to sum slowly through the rectal tube while examines the patient under the fluoroscopic screen The mixture should be at body temperature and stirred continuously during administration It should not be further given without instruction Various X-rays are taken to diagnose the problem Then, it is removed by cleansing enema or by a laxative
AFTER CARE A laxative or cleansing enema is often given after the test to empty the large bowel Stools are white for 24 to 72 hours after the examination Encourage the client to increase the liquid intake to prevent fecal impaction Instruct the client to report any pain, bloating, absence of stool or bleeding
COMPLICATIONS Fecal impaction if the bowel is not cleaned immediately Pain & bleeding.
