Should barium enema be the next step following an incomplete colonoscopy?
Summary of "Should barium enema be the next step following an incomplete colonoscopy?"
INTRODUCTION:
Double contrast barium enema (DCBE) is used to screen and diagnose colorectal disease and is often recommended following an incomplete colonoscopy. The purpose of this study was to determine the value of DCBE following an incomplete colonoscopy. MATERIALS AND
METHODS:
A retrospective review was conducted of all patients who had an incomplete colonoscopy at Kaiser Permanente, Los Angeles in a 6-year period. Patient data was extracted from the endoscopy and radiology databases. Variables collected included demographics, indication for colonoscopy, reason for incompletion, findings of DCBE, and findings of repeat colonoscopy if subsequently performed.
RESULTS:
The incomplete colonoscopy rate was 1.6%. The mean age was 62 years with a predominance of females. The most common indication for colonoscopy was screening. The most frequent reason attributed to an incomplete colonoscopy was patient discomfort. Two hundred thirty three patients underwent DCBE and 42 patients underwent a repeat colonoscopy without DCBE; 13.3% of the DCBE were of poor quality and could not be interpreted. A repeat colonoscopy following DCBE was performed in 7% of patients. In 50% of these patients, the repeat colonoscopy revealed significant findings not noted on the DCBE or ruled out positive DCBE findings. In patients who had repeat colonoscopy without DCBE, completion rate was 95%.
CONCLUSION:
The rate of incomplete colonoscopy in a high-volume modern endoscopy unit is extremely low. DCBE following incomplete colonoscopy has limited value. A repeat colonoscopy under deeper sedation and/or better bowel preparation may be the preferred next step.
Affiliation
Department of Gastroenterology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA.
Journal Details
This article was published in the following journal.
Name: International journal of colorectal disease
ISSN: 1432-1262
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20652709
- DOI: http://dx.doi.org/10.1007/s00384-010-1014-6
Medical and Biotech [MESH] Definitions
Barium Radioisotopes
Unstable isotopes of barium that decay or disintegrate emitting radiation. Ba atoms with atomic weights 126-129, 131, 133, and 139-143 are radioactive barium isotopes.
Barium Compounds
Inorganic compounds that contain barium as an integral part of the molecule.
Enema
A solution or compound that is introduced into the RECTUM with the purpose of cleansing the COLON or for diagnostic procedures.
Colonoscopy
Endoscopic examination, therapy or surgery of the luminal surface of the colon.
Cathartics
Agents that are used to evacuate the bowels to eliminate ingested NOXAE or to prepare for COLONOSCOPY.
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