Technique and evaluation of the double contrast ileostomy enema

A simple method for double contrast examination of the distal ileum in patients with a terminal ileostomy is described, using stomal intubation with a Foley catheter, syringe injection of barium, and air insufflation with smooth muscle relaxation. In 40 examinations the median length of ileum filled was 55 cm (range 20 to 140) with 38% of this length visualised in double contrast in a single view. The prestomal ileum was demonstrated clearly in 85%. Nine out of 18 patients with an abnormal ileostomy enema also had a barium follow through examination. The ileostomy enema made a significant contribution to the diagnosis in five of the nine patients.