What is the role of barium enema exam in the diagnosis of appendicitis?

Updated: Jul 23, 2018
  • Author: Sandy Craig, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

In the past, barium enema examination was used to diagnose appendicitis; in the era of ultrasonography and CT scanning, barium enema study has essentially no role in the diagnosis of acute appendicitis.

A single-contrast study can be performed on an unprepared bowel. Absent or incomplete filling of the appendix coupled with pressure effect or spasm in the cecum suggests appendicitis. The typical radiologic sign of appendicitis is the "reverse 3," which typically manifests as an indentation of the cecum. However, the appendix cannot be visualized in 50% of healthy individuals; therefore, barium enema lacks reliability.

Go to Imaging of Appendicitis for more information on this topic.


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