Double contrast barium enema (overview)

Last revised by Andrew Murphy on 23 Mar 2023

The double contrast barium enema is rapidly being replaced by CT colonography, but remains in some centers for:

The barium enema procedure is contraindicated in certain conditions:

Single contrast barium enema is not suitable in these situations because it is less sensitive at detecting small polyps and early changes of inflammatory bowel disease.

The 'double contrast' refers to the use of positive and negative contrast agents to increase the sensitivity of the examination.

The double contrast study is sensitive to visualize mucosal irregularities.

  • positive contrast: barium or barium-like agent, e.g. Gastrografin

  • negative contrast: air or CO2

See also

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Cases and figures

  • Case 1: diverticular disease
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  • Case 2: lead pipe bowel
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  • Case 3: rectal carcinoma
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  • Case 4: sigmoid apple core tumor
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  • Case 5: malignant rectal polyp
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  • Case 6: colon cancer
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