Comparisive Study The Value Between Oral Suspension Meal Of Barium Sulfate With Mannitol And Conventional Barium Enema In The Diagnosis Of Chronic Appendicitis

Objective:To investigate the value of oral suspension meal of barium sulfate with mannitol in the diagnosis of chronic appendicitis. Methods:analysis 226 patients with chronic appendicitis who were examined by x-ray gastrointestinal series with oral suspension meal of barium sulfate with mannitol(116 cases) and conventional barium enema(110 cases) respectively, and then they were confirmed by surgical pathology. The cases were divided into two groups(A and B) Group A with 116 patients were examined by oral meals. Group B with 110 patients were examined by conventional barium enema. The preparation before examination of the patients in the two groups were stopped to eat any food and drugs that could not be absorbed by X-ray before three days examination, for instance Bismuth and Calcium contained within the food and drugs. All of the patients were fasted of water and food before 12 hours of examination. The patients in Group A were firstly examined by chest and abdomen fluoroscope. And then the duodenum, jejunum, ileumn and ileocecus were observed after oral suspension meal of barium sulfate with mannitol. The last, the appendix would be observed that whether display or not. The bowel adjacent to the appendix would be displaced in appropriate place by compression device if it was necessary. After 72 hours later, the patients in Group A were observed the round of appendix by abdomen clairvoyance to explore the emptying. The patients in group B were injected suspension of 70%-80% BaSO4 300ml by anal, afterward ordinally to observe the colon and appendix. The patients in the control group were cleaned the bowel 4 times 4 hours before examination. And then used conventional barium enema to observe the appendix. Results: Group A with 116 cases displayed the appendix after 1 hour, in which,98 cases showed rough edge,irregular or multiple narrow cavity of the appendix,72 cases showed the distortion of the appendix,28 cases showed adhesion between the terminal ileum and appendix, the appendix developed partly had 19 cases, the far-end swelling in the narrow part of the appendix had 29 cases.86 cases retained barium in the appendix after 72 hours.pathology: 116 cases represented the infiltration of the lymphocyte, plasma cell and eo-sinophilic leukocytes, the connective tissue fiber hyperplasia,31 cases had granulation tissue and fibrosis,the appendix cavity occlusion had 10 cases.106 cases had a precise diagnosis by oral suspension of X-ray. The accuracy of diagnosis were 91.38%(106/116). Group B with 110 cases displayed the appendix,49 cases showed irregular edge of the appendix,32 cases showed the distortion of the appendix,8 cases showed adhesion between the terminal ileum and appendix, the appendix developed partly had 10 cases, the far-end swelling in the narrow part of the appendix had 11 cases.36 cases retained barium in the appendix after 72 hours, pathology: 110 cases represented the infiltration of the lymphocyte, plasma cell and eo-sinophilic leukocytes, the connective tissue fiber hyperplasia,21 cases had granulation tissue and fibrosis,the appendix cavity occlusion had 7 cases. the accuracy of group B with conventional barium enema were 57 of 110 cases(51.82%) (57/110) (x 2=43.95, P< 0.01).Conclusion:x-ray gastrointestinal series with oral suspension meal of barium sulfate with mannitol is useful methods in the diagnosis of chronic appendicitis.