Gastrointestinal Radiology > Procedures > Defecography > Defecography (5)


Defecography (cont.)

Procedure

  1. A preliminary, private interview with the patient, discussing the details of the anorectal problem and the purpose of the examination, is critical. The examination is embarrassing for many patients, and the personal interview may put them at ease. 

  2. After the fluoro room is set up and the patient is gowned, ask the patient to sit on the Brunswick Chair to familiarize him/her with the commode and to permit the radiologist to check the operation of the fluoroscope and spot imaging device. Take a preliminary spot image to check the radiographic technique. 

  3. Place the patient in the left lateral (Sims) position on a stretcher in the fluoroscopic room. Using a lubricated gloved finger, gently examine the anal canal to determine its muscle tone, orientation, and strength of voluntary muscle contraction. 

  4. Then, lubricate the disposable enema tip attached to the caulking gun and gently insert it into the patient's rectum. Instill the thick barium paste (Anatrast or Evacu-Paste) into the rectum until the patient reports a sensation of rectal fullness - but avoid producing a feeling of urgency. During removal of the enema tip, squeeze a small amount of the barium into the anal canal and onto the skin around the external anal opening to mark their locations.


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