J Korean Soc Coloproctol.  2006 Oct;22(5):298-300.

Is Barium Enema Prior to Ileostomy Closure Necessary?

• Lee MR
• Lee MJ
• Kim JH
• Hwang Y

Abstract

PURPOSE
A barium enema is frequently performed to check for healing prior to ileostomy closure, but there have been reports that ileostomy closure without a contrast study is safe in selected patients. The aim of this study was to assess the necessity of a routine barium enema prior to ileostomy closure.
METHODS
Between January 1994 and June 2005, 51 patients with a temporary loop ileostomy who had a barium enema prior to ileostomy closure at Chonbuk National University Hospital were retrospectively reviewed. These patients were divided into 2 groups, the protective ileostomy group and the ileostomy-after-leakage group. To examine the necessity of a routine barium enema prior to ileostomy closure, we assessed whether the barium enema results changed management and whether there were pelvic sepsis and obstructive symptoms following ileostomy closure.
RESULTS
In the protective ileostomy group (n=39), the barium enema was performed after a mean of 59 days (range: 27~151 days). There were no abnormal findings at the barium enema, no schedule changes, no pelvic sepsis, and no obstructive symptoms following ileostomy closure. In the ileostomy-after-leakage group (n=12), the barium enema was performed after a mean of 54 days (range: 30~82 days). In 2 patients, with barium enemas at 33 days and 36 days, an anastomotic leakage was found, and ileostomy closure was delayed.
CONCLUSIONS
In patients with a protective ileostomy, a barium enema prior to ileostomy closure is unnecessary, but in patients with an ileostomy after leakage, barium enema should be considered.

Keyword

Ileostomy closure; Barium enema

MeSH Terms

Anastomotic Leak
Appointments and Schedules
Barium*
Enema*
Humans
Ileostomy*
Jeollabuk-do
Retrospective Studies
Sepsis
Barium