Single Contrast Barium Enema (cont.)
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Conduct of the Examination
(cont.) |
- Roll
the patient back into the RPO position.
- Again, instruct the assistant to
partially unclamp the tubing and allow the barium to slowly flow by
gravity through the colon to the cecum while you pan back and forth with
the fluoroscope between the head of the barium column and the splenic
flexure region.
- When the cecum is well filled, perform graded compression
with the balloon paddle or F-Spoon to get good see-through penetration of
the barium.
- Take a spot image of the cecum in the RPO or supine position with
graded compression. When possible, also include the barium filled terminal
ileum.
![BE RPO patient position](0_RPO.jpg) ![BE Cecum spot](BE_Cecum_spot.jpg)
NOTE: Complete cecal filling is
confirmed by identifying at least one of three landmarks: the appendix,
an appendiceal stump, or the ileocecal valve.
NOTE: If an "air lock" forms in the cecum and it will not fill
with barium, turn the patient into a right lateral position, or even
into a RAO position. This should cause the air to escape from the cecum
into the left colon and be replaced by barium. After this, the
compression spot images of the cecum can be obtained, as usual.
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