Enema for low obstruction in newborn

  • Patient preparation: none
  • Contrast used: high osmolar water soluble to make enema therapeutic as well as diagnostic or barium, dilute contrast using 1 part contrast : 2 parts sodium chloride if < 1 year old or 2 parts tap water if > 1 year old
  • Technique: red rubber catheter, tape tip in securely, use gravity or gentle hand injection to instill contrast, start contrast with patient in a lateral position, turn the patient then to supine and to prone in order to opacify the entire colon with contrast and reflux the terminal ileum
  • Images to obtain: scout AP abdomen, AP and lateral abdomen once entire colon is opacified
  • Looking for: meconium ileus, meconium plug, ileal atresia, colon atresia, Hirschsprung disease
  • Post procedure tasks: if meconium ileus is encountered, perform enema for reduction of meconium ileus