This procedure is similar to a barium swallow except that the barium is administered into the rectum using an enema. Under X-ray, it highlights abnormalities of the lower part of the bowel.


A solution containing a substance called barium is drunk, usually on an empty stomach. Under X-ray, the barium becomes visible in the oesophagus, stomach and gastro-intestinal tract. The barium is excreted in the faeces, which are white and powdery for a day or two afterwards.


A biopsy is the removal of a small amount of tissue, under local or general anaesthetic, for examination under the microscope. The type of cells present can be identified and an accurate diagnosis of the medical condition usually made. Biopsies can be performed on all parts of the body including the skin, lymph nodes, bowel, liver, kidney and so on.


This test is done if it is suspected that a child has an infection in the bloodstream (sepsis). It is usually done in a hospital setting, as a child who is indeed septic usually needs to be hospitalised. A small amount of blood is drawn from a vein, just as in a normal blood test, but in very sterile conditions. The blood is mixed with a special culture liquid, then sent to the laboratory where it is incubated at a certain temperature to see if any germs grow. These can then be identified, and tested to see which antibiotics will be effective in treating them.


X-rays of the wrists in children can often be used as an indication of whether a child’s growth is in accordance with his chronological age. It can also be used to estimate ultimate height in children with short or tall stature (see p. 354-6).


In this test, which is performed under local anaesthetic in a hospital setting, a needle is inserted through the skin into the hip bone and a small amount of bone marrow extracted. It is generally performed if leukaemia or other similar forms of cancer are suspected.


This test is only performed in a hospital setting, under sedation or anaesthesia. A fine catheter (tube) is passed into the heart via a vein in the thigh, and the internal pressures blood, can be measured. It provides information which is important in the assessment of various heart conditions, especially congenital heart disease.