Radiology Of The Colon

Paulina W, dr., SpRad.

Medical Faculty
Cenderawasih University
Radiology of The Colon
• Barium Enema :
Colon Inloop

• US Study :
CT Scan
MRI
Barium Enema
Methods :
1. Double contrast, the method of choice
to demonstrate mucosal pattern.
2. Single contrast, uses :
a. Children, since it is usually not necessary
to demonstrate mucosal pattern.
b. Reduction of an intussusception.
Indications :
1. Change in bowel habit.
2. Pain.
3. Mass.
4. Melaena.
5. Obstruction.
NB : If a tight stricture is demonstrated, only
run a small volume of barium proximally
the barium may impact.
Contraindications :
Absolute :
1. Toxic megacolon.
2. Pseudomembranous colitis.
3. Rectal biopsy within the previous 3 days (it
is preferable to wait for 7 days).

Relative :
4. Incomplete bowel preparation.
5. Recent barium meal.
Contrast Medium :
• Barium Sulfat (w/v. 500 ml for more, as
required).

Patient Preparation :
• For 3 days prior to examination.
• Low residue diet.

On the day prior to examination :

1. Fluids only.
2. Laxant (oral).
3. Dulcolax suppositoria.
On the day of the examination :
• A colonic washout.
• At least 1 hour must elapse before
starting the barium enema to allow
time for the colon to absorb the
excess water.

Preliminary film, Plain abdominal film :

a) To assess bowel preparation.
b) To exclude toxic megacolon.
Imaging And Lesion Of Hollow Organ
 ABNORMAL RADIOLOGIC
FINDINGS OF THE COLON
Filling Defect in the caecum :
I. Inflammatory process :
• Appendicitis / abcess.
• Tuberculosis infection.
• Amoeboma.
• Crohn’s disease.
II. Benign neoplasms :
• Carcinoid tumor.
III. Malignant neoplasms :
• Adeno Ca.
• Lympoma Ma.
• Metastastic process.
IV. Miscellaneus :
• intussusception
Ulcerative lesions of the colon :

I. Infection process (colitis).

II. Malignancy process (primary or metastase).
Narrowing of the colon
I. Chronic infection.
II. Malignancy process.
III. Miscellaneus :
• Inchaemia.
• Adhesive band.
• Radiation injury.
Large bowel obstruction :
I. Volvunus
Intussusception (Invaginasi).
Adhesions.
II. Inflamatory strictures.
III. Malignancy process.
IV. Fecal impaction :
• Meconeum plug syndrome.
• Hirschsprung’s disease.
• Hernia.
Abnormal position of the colon
I. Displacement, by :
• intra abdominal masses
• Extrinsic colon masses.
II. Abnormalities in rotation.
III. Hernia.
Abnormal diffuse dilatation of
the colon :
I. The cathartic colon.
II. Idiopathic megacolon :
• Functional.
• Neurogenic.
III. Due to low obstruction (imperforate
anus, Ca., etc).
IV. - Reflex ileus, paralytic ileus.
- Electrolyte imbalance.
cocygeus
 ASSESSEMENT IN
DIAGNOSTIK IMAGING OF
COLON