Gastrointestinal Radiology

, Volume 14, Issue 1, pp 357–359 | Cite as

The diagnostic value of combining flexible sigmoidoscopy and double-contrast barium enema as a one-stage procedure

  • Yukio Saito
  • Premysl Slezak
  • Carlos Rubio


Results from the consecutive examination of 675 patients using both flexible sigmoidoscopy and a double-contrast x-ray technique were analyzed with special reference to the detection of polyps in the rectum and sigmoid colon. A total of 193 polyps were found. Histological examination of 93 polyps revealed that half of those less than 5 mm in diameter and 93.3% of those more than 6 mm in diameter were adenomas. The x-ray examination failed to detect 44% of the proven adenomas smaller than 5 mm, 35.3% of those 6-10 mm in size, and 16.7% of those larger than 11 mm in diameter. These rates were significantly higher than those of flexible sigmoidoscopy, which had corresponding miss rates of 8, 11.2, and 0%, respectively. The double-contrast barium enema (DCBE) failed to detect every second polyp in the rectosigmoid. Every second polyp in the same region proved to be adenoma. The DCBE combined with flexible sigmoidoscopy gives the most reliable and precise diagnosis of various disorders of the rectum and sigmoid colon.

Key words

Colon x-ray examination Flexible sigmoidoscopy Adenoma 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Morson BC, Dawson IMP:Gastrointestinal Pathology 2nd ed. Oxford: Blackwell, 1979, pp 615–674Google Scholar
  2. 2.
    Muto T, Kamiya J, Sawada T et al: Small “flat adenoma” of the large bowel with special reference to its clinico-pathologic features.Dis Colon Rectum 28:847–851, 1985Google Scholar
  3. 3.
    Rodney WM, Randolph JF, Peterson DW: Cancellation rates and gas scores for air contrast barium enema immediately after 65-cm flexible sigmoidoscopy. A randomized clinical trial.J Clin Gastroenterol 10:311–314, 1988Google Scholar
  4. 4.
    Maxfield RG, Maxfield CM: Colonoscopy as a primary diagnostic procedure in chronic gastrointestinal tract bleeding.Arch Surg 121:401–493, 1986Google Scholar

Copyright information

© Springer-Verlag New York Inc. 1989

Authors and Affiliations

  • Yukio Saito
    • 1
    • 3
  • Premysl Slezak
    • 1
  • Carlos Rubio
    • 2
  1. 1.Department of Diagnostic RadiologyKarolinska HospitalStockholmSweden
  2. 2.Department of PathologyKarolinska HospitalStockholmSweden
  3. 3.Department of SurgeryUniversity of TokyoJapan

Personalised recommendations