(3) Lateral rectum, taken as a cross table ventral lateral decubitus for
double contrast exam.
AP axial (butterfly position).
Bilateral decubitus, taken as part of the double contrast exam.
b. Preparation of Patient and Scheduling.
(1) Inpatient. Ordinarily, the x-ray department in cooperation with the
referring ward accomplishes scheduling. The x-ray department makes the appointment
for a special date and time upon receipt of a properly prepared request form from the
ward. Ward personnel generally prepare the patient for the examination. Normally, the
patient is given a cathartic about 8 to 12 hours before the examination, with the
approval of the patient's physician. A laxative is prescribed for the patient in conjunction
with a cleansing enema. A simple cleansing enema may be given to the patient about
an hour before the examination. In most cases, breakfast is withheld. However, a light
breakfast is sometimes allowed.
(2) Outpatient. This procedure is essentially the same as for the inpatient.
When the appointment is made, the outpatient is given instructions as to pre-
examination preparation. Arrangements should be made with a ward or nearby
dispensary to provide facilities for the cleansing enema if the patient has no means for
accomplishing this himself.
c. Preliminary Procedure.
(1) A routine setup of the fluoroscopic and radiographic facilities should be
(2) Contrast medium should be prepared in accordance with established
routine or as prescribed by the radiologist. (Note: It is imperative that the specialist
made certain that the contrast mixture is prepared exactly as prescribed. The type of
examination, single-contrast or double-contrast, will determine the thickness of the
suspension.) The contrast medium must be worked into a thoroughly mixed suspension
using either an electro-mechanical device or the spoon or paddle method.
(a) Step 1. Fill the container with water to about half full. Ordinarily,
the water should approximate normal body temperature.
(b) Step 2. Add the correct amount of barium, and mix into a
The following accessory items are required to administer the contrast