Background: Double-contrast barium enema (DCBE) is a safe, noninvasive, inexpensive, and cost-effective imaging technique. It offers complete visualization of the colonic mucosa. Inflammatory bowel disease (IBD) including Crohn's disease can easily be diagnosed using the DCBE technique. Aims and objectives: To demonstrate the accuracy of DCBE in diagnosis of Crohn's colitis. Materials and methods: A retrospective review of DCBE examination in 57 patients of colonic Crohn's disease was performed. A barium suspension of medium viscosity at 100% w/v was used. Each DCBE was evaluated by two experienced gastrointestinal radiologists independently without any knowledge of the colonoscopic findings. Results: In 89% of patients, the radiological diagnosis corresponded with the clinical diagnosis of Crohn's disease. Five patients were misclassified as tubercular and one as ulcerative colitis. Asymmetric disease with rectal sparing and discrete ulcers were the most commonly observed radiological findings. About 19% of patients showed the features of early Crohn's as suggested by the finding of aphthoid ulcerations with background of the normal mucosa. The left-sided colon was more commonly involved compared with the right side with the transverse colon being the most commonly involved part. Conclusion: The double-contrast examination technique, because of its high accuracy in diagnosing Crohn's disease and due to its relatively specific signs, is suggested to be the preferred examination in the radiological assessment of inflammatory bowel disease.
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