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Intracolonic pressure measurements during hydrostatic and air contrast barium enema studies in children
D Zambuto1, R T Bramson, J G Blickman
1Department of Radiology, Massachusetts General Hospital, Boston, 02114, USA.
Insights
Intracolonic pressure remains low during conventional barium enemas in children. However, air contrast barium enema studies show sharp, intermittent pressure spikes during air insufflation.
Area of Science:
- Pediatric Radiology
- Gastrointestinal Imaging
Background:
- Intraluminal pressure dynamics during pediatric enema procedures are not well characterized.
- Understanding these pressures is crucial for patient safety and procedural optimization.
Purpose of the Study:
- To prospectively measure intraluminal colonic pressure changes in children during hydrostatic and air contrast barium enema studies.
- To compare pressure variations between different enema techniques.
Main Methods:
- Dynamic intracolonic pressure was recorded in 26 children using a specialized pressure-measuring device.
- Measurements were taken during hydrostatic barium enema, air contrast barium enema, and water-soluble contrast enema examinations.
- Pressure data were collected with the contrast system open and closed.
Main Results:
- During hydrostatic barium enemas, colonic pressures were generally low, averaging 30-50 mm Hg, with peaks over 100 mm Hg during Valsalva maneuvers.
- Air contrast barium enema studies demonstrated significant, rapid pressure fluctuations following manual air insufflation.
Conclusions:
- Conventional hydrostatic barium enemas in children are associated with low intracolonic pressures.
- Air insufflation during air contrast barium enema studies can lead to intermittent, high-pressure peaks.
Purpose:
To prospectively evaluate intraluminal pressure changes in the colon of children undergoing conventional hydrostatic (barium and water-soluble contrast material) and air contrast barium enema studies.
Materials And Methods:
Dynamic intracolonic pressure was measured in 26 children undergoing hydrostatic barium (23% wt/vol) enema studies, air contrast barium enema studies, or water-soluble contrast material enema examinations. Measurements were obtained with a measuring device capable of recording rapid changes in pressure. Pressure measurements were obtained with the contrast reservoir system open (contrast material was free to run through the tubing into the patient's colon) and closed (tube was clamped).
Results:
The colonic pressures during the filling phase with liquid contrast material were equal to those elsewhere at the same level with the hydrostatic system. Mean pressure ranged from 30 to 50 mm Hg with peaks of more than 100 mm Hg during Valsalva maneuvers. During air contrast barium enema studies, sharp pressure increases and rapid swings in the intracolonic pressure occurred during and after manual insufflation of air.
Conclusion:
During conventional hydrostatic barium enema studies, intracolonic pressures remain low. During air insufflation, there were intermittent high, sharp pressure peaks.