Double-contrast barium enema technique.

During a double-contrast barium enema the radiologist interacts with the patient, the controls of the fluoroscope, and the image on the television monitor. The radiologist paints an image of the colon; the barium is the paint, the colon is the canvas. The radiologist manipulates the barium pool, the air column, and the patient to create images. Although the radiologist may have a plan going into the examination, the game plan is altered by the patient's ability to tolerate and perform the study, the length of the colon, and pathology encountered. If the radiologist understands the goals to be achieved, the studied can be tailored to fit what is happening in the fluoroscopic suite.