The role of contrast enema in the diagnosis and evaluation of large intestines pathologies in children: a crosssectional descriptive study carried out at Kenyatta National Hospital Radiology Department

Abstract

The widespread use of contrast radiography has made it easier to diagnose and treat many Gastrointestinal tract (GITJ conditions in both children and adults. Apart from barium, over contrast media such as Gastrografin and air have been employed as contrast with good results

OBJECTIVE The main objective of the study was to determine the role of contrast enema in the diagnosis and management of large bowel pathologies in children aged twelve years and below. The other objectives were to determine the common indications for contrast enemas, disease pattern in children undergoing enemas, age and sex distribution of common pathologies.

STUDY DESIGN AND SETTING A cross sectional descriptive study was carried out at Kenyatta National Hospital radiology department.

METHODOLOGY A total of 92 patients who consented were entered from November 2009 to November 2010. Only 5 patients did not consent. Contrast enema using barium sulphate or iodinated water soluble was carried out on a Fluoroscopy Machine, Diagnoset 15 Model, manufactured by Phillips in 1992.

RESULTS Ninty two patients were studied by contrast enema. The main radiological findings were: normal (63 %J, hirshsrung (17.4%) atreasia with fistula (5.4 %) Atreasia without fistula(5.4%), feacal impaction (3.3% ) meconium plug(3.3%) parasitic infestation(1.1 %).Ancillary investigations done were plain films(14.1 %.) and Ultrasound(10.9%) of patients and biopsy done on 17.4 % of patients. The main clinical question was to evaluate value of contrast enema in children suspected to have large bowel pathology

CONCLUSION Contrast enema examination was found to be highly sensitive (92%) for congenital obstructive colonic pathologies, which correlated well with other local studies that had put sensitivity between 75% - 95% The examination is nonspecific for patients suspected to have inflammatory conditions.