A Pediatric Radiology Textbook and Pediatric Radiology Digital Library
Enema for Hirschsprung disease
Patient preparation: none
Contrast used: barium or high osmolar water soluble to make enema therapeutic as well as diagnostic, dilute contrast using 1 part contrast : 2 parts sodium chloride if < 1 year old or 2 parts tap water if > 1 year old
Technique: short enema tip if possible to help look for ultrashort Hirschsprung disease, tape tip in securely, start contrast with patient in a lateral position, turn the patient then to supine and then to prone in order to opacify the entire colon with contrast and reflux the terminal ileum
Images to obtain: — Scout – AP abdomen and lateral rectum — Lateral image of rectum once it is distended with contrast — Images of any transition zone — AP abdomen and lateral rectum once entire colon is opacified
