Sonography as an aid to diagnosis of caecal carcinoma in the elderly

Many elderly patients with suspected colonic neoplasm are referred to radiology departments for barium enema. Despite routine use of laxatives and colonic washouts and employment of antispasmodic drugs, problems occur with faecal residue and poor retention of barium. This may lead to inadequate demonstration of the caecum. Over a 6-month period sonography following the barium enema allowed a confident diagnosis of a caecal mass lesion to be made in five such patients, whose barium enema had been suspicious but suboptimal. It is suggested that in some patients sonography, where positive, may shorten and facilitate investigation.