Pediatric enema single contrast

  • Patient preparation: none
  • Contrast used: barium or high osmolar water soluble if there is a need for a therapeutic as well as diagnostic enema, dilute contrast using 1 part contrast : 2 parts sodium chloride if < 1 year old or 2 parts tap water if > 1 year old
  • Technique: place tip in rectum with patient in left lateral position and start contrast, turn patient to left lateral, then LPO, then supine, then RPO, then prone
  • Images to obtain:
    — Take 3 images without compression: left lateral – image of rectum, deep left posterior oblique – image of rectosigmoid, mid left posterior oblique – image of sigmoid
    — Take 3 images with compression: right posterior oblique – image of splenic flexure, left posterior oblique – image of hepatic flexure, AP – image of ileocecal valve and cecum
    — AP – image of ileocecal valve without compression
    — Overheads – PA (prone), butterfly, post evacuation
  • Looking for: obstruction, strictures
  • Post procedure tasks: if barium used advise patient to drink plenty of liquids to wash barium out of system and that barium will lighten color of stools