Diagnostic yield from barium enemas: a study among patients referred by general practitioners and hospital outpatient departments.

Although the double contrast barium enema is the standard radiological examination of the colon, it is not universally available to patients referred by their general practitioners. A retrospective survey of all double contrast barium enemas carried out over a two year period in one health district was undertaken to determine the diagnostic yield of pathological findings for patients referred by general practitioners and hospital outpatient departments and for patients who had rigid sigmoidoscopy prior to the enema and those who did not. A total of 530 patients were studied. The diagnostic yield for the hospital outpatients was 41.6% and in the general practitioner group 35.6%. In the patients who had rigid sigmoidoscopy the yield was 42.7% compared with 32.6% in those who had no prior sigmoidoscopy. It is concluded that the withdrawal of direct access for barium enemas to general practitioner patients in this district because of a low diagnostic yield cannot be justified. The lower diagnostic yield in the patients who did not have sigmoidoscopy supports the policy of requiring this examination prior to all barium enemas.