Vellacott K D, Virjee J
Gut. 1986 Feb;27(2):182-5. doi: 10.1136/gut.27.2.182.
All 1358 referrals for barium enemas at Bristol Royal Infirmary in 1981 were studied. The overall diagnostic yield for colonic or distal ileal pathology was 33% with 75 (5.5%) cancers detected. General practitioner requested enemas constituted 25.8% of the total undertaken and their diagnostic yield was equal to hospital outpatient requested enemas. Medical and surgical diagnostic yields were similar for both inpatient and outpatients though the indications varied. Women predominated by 3:2 in all age groups. In the under 40's the yield was low (19.8%) except for inflammatory bowel disease. When related to symptoms the lowest yield was obtained for the investigation of abdominal pain (25%), particularly in women, except in those admitted as inpatients. The clinicians were wrong in diagnosing abdominal or pelvic masses as being of colonic origin in over 50% of cases. It is suggested that yield could be improved by being more selective in patients under 40, more use being made of suitable faecal occult blood testing, and ultrasonic scanning of abdominal masses before barium enema.
对1981年布里斯托尔皇家医院的1358例钡灌肠转诊病例进行了研究。结肠或回肠末端病变的总体诊断率为33%，共检测出75例（5.5%）癌症。全科医生要求的灌肠占总数的25.8%，其诊断率与医院门诊要求的灌肠相同。尽管住院患者和门诊患者的诊断指征不同，但内科和外科的诊断率相似。在所有年龄组中，女性占比为3:2。在40岁以下人群中，除炎症性肠病外，诊断率较低（19.8%）。与症状相关时，腹痛检查的诊断率最低（25%），尤其是女性，住院患者除外。在超过50%的病例中，临床医生将腹部或盆腔肿块误诊为结肠来源。建议对40岁以下患者进行更有选择性的检查，更多地使用合适的粪便潜血试验，并在钡灌肠前对腹部肿块进行超声扫描，以提高诊断率。
