The Role Of The Barium Enema Examination In The Diagnosis And Evaluation Of The Pattern And Radiological Features Of Diseases Of The Large Bowel At Kenyatta National Hospital

Abstract

In this retrospective study over a period of five years, 1980 - 1984, on the value of barium enema examination at Kenyatta National Hospital, some interesting findings have been encountered. In a total of 656 booked cases, only 382 (58.3%) attended and were examined. Of the 382 cases, 61 (15.9%) were of no diagnostic value due to poor bowel preparation, and 56 (14.6%) were untraceable leaving only 265 cases which were analyzed. Of the 265 cases, radiologists reported normal in 184 (69.4%) cases. However, further analysis into the files of these cases revealed 7 cases of missed colonic pathologies 0 Hence, the true normal cases were 177 (66.8%). In general, the specificity of barium enema examination in ruling out colonic pathology at Kenyatta National Hospital was 96.2% (177/184). The sensitivity, efficiency and efficacy vary with the type of colonic lesion being investigated. The commonest colonic lesion seen in this study at Kenyatta National Hospital was Aganglionosis, found in 16 (19.8%)of the 81 true positive cases. After analysis of clinical signs and symptoms of all the 265 cases, and reasons for the barium enema examination request by the clinicians, it was found that 145 (54.7%) cases did not need this investigation for a diagnosis to be made. In terms of cost, a saving of Kshs.43,500/- could have been made.