Barium studies

There has been a slow but steady decline in the volume of barium studies performed in the world during the past 20 years. The recent literature shows a gradual replacement of the barium studies with endoscopy, capsule endoscopy, and new radiological methods (computed tomography enterography or magnetic resonance enterography) in most clinical situations, such as neoplasm, the screening of patients with familial polyposis, high-grade small bowel obstructions, and active or obscure GI bleeding. Moreover the clinical and diagnostic approach to the patient with abdominal pain has significantly changed with ultrasound being almost always the initial examination in a wide range of situations. However, barium studies are still the most common and accessible radiological methods, important particularly in situations when other new technologies are limited. The former allow correct diagnosis at a lower cost and fewer complications. For these reasons we decided to focus the chapter on two issues: intestinal malrotation and Crohn’s disease.