- A preliminary, private interview with
the patient, discussing the details of the anorectal problem and the
purpose of the examination, is critical. The examination is embarrassing
for many patients, and the personal interview may put them at ease.
- After the fluoro room is set up and the patient is gowned, ask the
patient to sit on the Brunswick Chair to familiarize him/her with the
commode and to permit the radiologist to check the operation of the
fluoroscope and spot imaging device. Take a preliminary spot image to check
the radiographic technique.
- Place the patient in the left lateral (Sims) position on a stretcher
in the fluoroscopic room. Using a lubricated gloved finger, gently
examine the anal canal to determine its muscle tone, orientation, and
strength of voluntary muscle contraction.
- Then, lubricate the disposable enema tip attached to the caulking gun
and gently insert it into the patient's rectum. Instill the thick barium
paste (Anatrast or Evacu-Paste) into the rectum until the patient
reports a sensation of rectal fullness - but avoid producing a feeling of
urgency. During removal of the enema tip, squeeze a small amount of the
barium into the anal canal and onto the skin around the external anal opening to mark
their locations.
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