The Correlation of Symptoms, Occult Blood Tests, and Neoplasms in Patients Referred for Double-Contrast Barium Enema

Abstract

One hundred and forty-nine patients (86 women) with a mean age of 64 years (52-74 years), referred for double-contrast barium enema (DCE), were invited to have fecal occult blood test and recto-sigmoidoscopy (60 cm) (RSS) before the DCE. Carbon dioxide was used for inflation at RSS to enable the two examinations to be done at the same time. Eight adenomas < 1.0 cm in diameter, 11 adenomas = 1.0 cm in diameter, and 5 carcinomas were diagnosed in altogether 23 patients. There was no correlation between symptoms, diverticula, or neoplasm, but a positive rehydrated Hemoccult II test was correlated to the presence of neoplasms (cancer and adenoma 1.0 cm in diameter), but Hemoccult is not suitable as selection basis for work-up of symptomatic subjects. To diagnose colorectal neoplasms, we have to accept a certain number of negative work-ups of the large bowel. If DCE is chosen for work-up of the large bowel, it has to be combined with rectosigmoidoscopy (60 cm).

Key Words:

• Colorectal neoplasm
• double barium enema
• Hemoccult II
• occult blood testing
• symptomatic patients