Pediatric Radiology

, Volume 16, Issue 4, pp 298–301 | Cite as

Correlation of double-contrast high-density barium enema, colonoscopy, and histology in children with special attention to disparities

  • D. A. Stringer
  • P. M. Sherman
  • N. Jakowenko


Colonoscopic and double-contrast high-density barium enema (DCBE) findings were correlated in 68 patients (39 boys and 29 girls) aged 6 months to 18 years (mean 11.6 years) evaluated over a 24-month period. There was excellent correlation in 53 patients (78.0%) and good correlation in another 3 (4.4%) who had identical diagnoses and only slightly differeing extent of disease reported. In 2 of these, DCBE showed more extensive disease, confirmed histologically in 1. Distal colitis seen on colonoscopy as reddening and neovascularity was missed on DCBE in 6 patients. Colonoscopy and DCBE failed to show a polyp in 1 patient each. One patient who had a normal DCBE and colonoscopy demonstrated a histological abnormality, and 1 patient with an abnormality on histology and DCBE was normal on colonoscopy. A disparity resulted from the time between procedures in 1 patient and observer error in another. This high correlation is far better than any previously reported in children, supporting the use of high-density barium sulfate and double-contrast barium enemas in pediatric patients.


Public Health Sulfate Barium Pediatric Patient Barium Enema 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Gans SL, Ament M, Christie DL, Liebman WM (1975) Pediatric endoscopy with flexible fiberscopes. J Pediatr Surg 10: 375PubMedGoogle Scholar
  2. 2.
    Cadranel S, Rodesch P, Peeters JP, Cremer M (1977) Fiberendoscopy of the gastrointestinal tract in children. Am J Dis Child 131: 41PubMedGoogle Scholar
  3. 3.
    Thoeni RF, Menuck L (1977) Comparison of barium enema and colonoscopy in the detection of small colonic polyps. Radiology 124: 631PubMedGoogle Scholar
  4. 4.
    Tedesco FJ, Waye JD, Raskin JB, Morris SJ, Greenwald RA (1978) Colonoscopic evaluation of rectal bleeding: a study of 304 patients. Ann Int Med 89: 907PubMedGoogle Scholar
  5. 5.
    Habr-Gama A, Alves PRA, Gama-Rodrigues JJ, Teixeira MG, Barbieri D (1979) Pediatric colonoscopy. Dis Colon Rectum 22: 530PubMedGoogle Scholar
  6. 6.
    Chong SKF, Bartram C, Campbell CA, Williams CB, Blackshaw AJ, Walker-Smith JA (1982) Chronic inflammatory bowel disease in childhood. Br Med J 284: 101Google Scholar
  7. 7.
    Williams CB, Laage NJ, Campbell CA et al. (1982) Total colonoscopy in children. Arch Dis Child 52: 49Google Scholar
  8. 8.
    Williams CB, Hunt RH, Loose H, Riddell RH, Sakai Y, Swarbrick ET (1974) Colonoscopy in the management of colon polyps. Br J Surg 61: 673PubMedGoogle Scholar
  9. 9.
    Laufer I, Mullens JE, Hamilton J (1976) Correlation of endoscopy and double-contrast radiography in the early stages of ulcerative and granulomatous colitis. Radiology 118: 1PubMedGoogle Scholar
  10. 10.
    Simpkins KC, Stevenson GW (1972) The modified Malmö double-contrast enema in colitis: an assessment of its accuracy in reflecting sigmoidoscopic findings. Br J Radiol 45: 486PubMedGoogle Scholar
  11. 11.
    Winthrop JD, Balfe DM, Shackelford GD, McAlister WH, Rosenblum JL, Siegel MJ (1985) Ulcerative and granulomatous colitis in children. Comparison of double- and single-contrast studies. Radiology 154: 657PubMedGoogle Scholar
  12. 12.
    Hassall E, Barclay GN, Ament ME (1984) Colonoscopy in childhood. Pediatrics 73: 594PubMedGoogle Scholar
  13. 13.
    Laufer I (1979) Upper gastrointestinal tract: technical aspects. In: Laufer I (ed) Double contrast gastrointestinal radiology with endoscopic correlation. Saunders, Philadelphia, pp 59–77Google Scholar
  14. 14.
    Franken EA (1982) Examination techniques and gastrointestinal symptoms in infants and children. In: Franken EA (ed) Gastrointestinal imaging in pediatrics, 2nd ed. Harper and Row, Philadelphia, pp 1–18Google Scholar
  15. 15.
    Geenen JE, Schmitt MG, Wu WC, Hogan WJ (1975) Major complications of colonoscopy: bleeding and perforation. Am J Dig 20: 231Google Scholar
  16. 16.
    Burdelski M (1978) Endoscopy in pediatric gastroenterology. Eur J Pediatr 128: 33CrossRefPubMedGoogle Scholar
  17. 17.
    Bigard M-A, Gaucher P, Lassalle C (1979) Fatal colonic explosion during colonoscopic polypectomy. Gastroenterology 77: 1307PubMedGoogle Scholar
  18. 18.
    Kozarek RA, Earnest DL, Silverstein ME, Smith RG (1980) Air-pressure-induced colon injury during diagnostic colonoscopy. Gastroenterology 78: 7PubMedGoogle Scholar
  19. 19.
    Laufer I, Smith NCW, Mullens JE (1976) The radiological demonstration of colorectal polyps undetected by endoscopy. Gastroenterology 70: 167PubMedGoogle Scholar
  20. 20.
    Bo-Linn GW, Vendrell DD, Lee E, Fordtran JS (1985) An evaluation of the significance of microscopic colitis in patients with chronic diarrhea. J Clin Invest 75: 1559PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1986

Authors and Affiliations

  • D. A. Stringer
    • 3
  • P. M. Sherman
    • 1
  • N. Jakowenko
    • 2
  1. 1.Department of Paediatrics (Division of Gastroenterology)The Hospital for Sick ChildrenTorontoCanada
  2. 2.Department of NursingThe Hospital for Sick ChildrenTorontoCanada
  3. 3.Department of RadiologyThe Hospital for Sick ChildrenTorontoCanada

Personalised recommendations