74280 Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administered

Name of the Procedure:

Radiologic examination, colon (double-contrast study, including scout abdominal radiograph(s) and delayed image(s))

Summary

A radiologic examination of the colon involves using high-density barium and air to create detailed images of the large intestine. This procedure helps in diagnosing various intestinal conditions by enhancing the contrast in radiographic images.

Purpose

The main goal is to identify abnormalities in the colon such as tumors, polyps, inflammatory conditions, or diverticulosis. It can reveal structural changes and assist in diagnosing unexplained gastrointestinal symptoms.

Indications

• Chronic abdominal pain
• Unexplained changes in bowel habits
• Blood in stool
• Suspected colorectal cancer
• Inflammatory bowel disease monitoring

Preparation

• Patients may need to fast for 12 hours prior to the procedure.
• A bowel prep might be prescribed to clear the colon.
• Patients should inform their doctor about any medications or health conditions.

Procedure Description

1. A preliminary "scout" radiograph of the abdomen is taken.
2. The patient lies on a radiographic table, and an enema tube is inserted into the rectum.
3. High-density barium is introduced into the colon via the enema tube.
4. Air is then introduced to achieve double-contrast, highlighting the inner lining of the colon.
5. Multiple radiographs are taken in different positions.
6. Glucagon may be administered to relax the bowel muscles.
7. Delayed imaging is done to capture how the barium moves through the colon.

Duration

The procedure typically takes about 45 minutes to 1 hour.

Setting

The examination is usually performed in a hospital's radiology department or an outpatient imaging center.

Personnel

• Radiologist
• Radiologic technologist
• Nurse (if sedation or glucagon is administered)

Risks and Complications

• Discomfort due to the insertion of the enema tube and air.
• Rarely, bowel perforation or allergic reactions to barium.
• Cramping or bloating during and after the procedure.

Benefits

• Provides detailed imaging for accurate diagnosis.
• Non-invasive compared to surgical diagnostic methods.
• Results are usually available quickly for prompt diagnosis.

Recovery

• Patients can generally resume normal activities immediately.
• Increased fluid intake is recommended to help clear barium from the system.
• Follow-up appointments may be scheduled based on results.

Alternatives

• Colonoscopy: More invasive but allows for biopsies.
• CT Colonography: Less invasive but may not be as detailed.
• Stool tests: Non-invasive but less specific.

Patient Experience

• Patients may feel bloating and discomfort during the procedure.
• Mild cramping can occur as air is introduced.
• Post-procedure, drinking plenty of fluids can help relieve any residual discomfort. Pain management is usually not necessary beyond mild over-the-counter options.