• Perforation
• Peritonitis
• Recent surgery
• Low colonic obstruction (splenic flexure and beyond)
• Ileus
• Constipation (for catharsis)
• Recto-vaginal fistula

Indications for dilute barium (30-50% w/v) studies

• Right colonic obstruction
• Distal small bowel obstruction
   

Radiographic Technique

• Spot Views:
  • Lateral rectum
  • Recto-sigmoid
  • Splenic & hepatic flexures
  • Cecum

   

• Overhead Films:
  • AP supine
  • Post-evacuation (a very important view)

Note:

Fluoroscope continuously and watch the head column of barium/Hypaque to detect short or small lesions (can be missed if too much contrast is used).

Can use high density barium for low colonic lesions and using double contrast technique (useful when sigmoid redundant or low lying deep pelvis)