Radiology, Vol 168, 35-37, Copyright © 1988 by Radiological Society of North America

ARTICLES

Diverticular disease: imaging with post-double-contrast sigmoid flush

JC Lappas, DD Maglinte, KK Kopecky, EM Cockerill and GA Lehman
Department of Radiology, Indiana University School of Medicine, Indianapolis.

In a prospective study, the effect of infusion of a low-density contrast material was evaluated as an adjunct to high-density, double- contrast imaging of the sigmoid colon. After double-contrast barium enema (DCBE) study, 52 consecutive patients with sigmoid diverticulosis received an additional 500-750-mL enema either with water or a 1.5% barium suspension for computed tomography. Rectosigmoid radiographs were evaluated for luminal distention, visualization of the interhaustral space, definition of diverticula, and interpretation of polypoid defects. While double-contrast views were excellent in 21% of patients, improvement in multiple factors by water or 1.5% barium flush resulted in improved sigmoid images in 65% and 75% of patients, respectively. Polyps were confirmed and artifactual defects confidently excluded. Sigmoid flush, particularly with low-density barium, is a simple adjunct to DCBE study that improves visualization of the diverticular sigmoid and increases interpretive confidence.

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