Pneumoperitoneum occurring during double-contrast enema

A case of pneumoperitoneum occurring during double-contrast barium enema is described. Cases reported to date indicate that colonic rupture during a double-contrast enema is likely to result in exit of air rather than barium from the colon. The diagnostic implicatons of this observation are considered. The potentially high pressure generated by bulb-type inflators is discussed, and caustion is advised against overdistending the colon during double-contrast enemas.