The expanded role of the barium enema in the evaluation of patients presenting with acute abdominal pain.

The role of the barium enema in the evaluation of patients with acute abdominal pain is well established. It is utilized in the diagnosis and treatment of several suspected clinical entities, including appendicitis, diverticulitis, intussusception, and volvulus. There is another group of patients in whom a vague clinical presentation and an indeterminate bowel gas pattern fail to clarify the diagnosis. The role of the barium enema has been expanded as an early diagnostic aid in the evaluation of these patients. Based on abdominal film findings, three patient categories are presented, in whom the early use of a "judicious" barium enema may safely and quickly contribute to the preoperative definition of the underlying disease process, allowing for the correct mode of therapy to be undertaken.