Barium Enema Flashcards
barium enema purpose
to study the form and function of the large intestine to detect abnormal conditions
performed as single or double contrast
barium enema contraindications
possible perforated hollow viscus
possible large bowel obstruction
appendicitis
clinical indications for barium enemas
colitis diverticulum intussusception neoplasms annular carcinoma polyps volvulus
colitis
inflammatory condition of the large intestine
ulcerative colitis
severe form of colitis
most commonly in young adults
chronic condition
long term bouts of ulcerative colitis may lead to
stovepipe or leadpipe colon
loss of haustral markings
diverticulum
outpouching of mucosal wall
diverticulosis
having numerous diverticula
diverticulitis
inflamed diverticula due to infection
is diverticula best demonstrated with a single or a double contrast BE ?
double contrast BE
intussusception
telescoping or invagination of one part of intestine into another
annular carcinoma
typical form of colon cancer
forms apple core or napkin ring
results in large bowel obstruction
polyps
saclike projections that project inward into the lumen of the intestine
volvulus
twisting of portion of intestine on its own mesentary
leads to mechanical obstruction
most common in men ages 20-50
barium enema patient prep
large bowel must be completely empty of its contents light evening meal prior bowel cleansing cathartics NPO after midnight 8HRS no gum chewing no smoking cleansing enema morning of exam (NO LAXITIVES MORNING OF EXAM)
contraindications to laxatives (cathartics)
gross bleeding
diarrhea
obstruction
inflammatory conditions
2 types of laxatives
- irritant laxatives
2. saline laxatives
irritant laxatives
ex: caster oil
rarely used for BE’s
Saline laxatives
magnesium citrate
magnesium sulfate
3 most common types of enema tips
- plastic disposable
- rectal retention
- contrast retention (double contrast)
T or F
retention catheters should be fully inflated only under fluoroscopic guidance provided by the radiologist because of potential danger of intestinal rupture
true
when is iodinated water soluble contrast used
in case of perforated or lacerated intestinal wall
or if pt. is scheduled for surgery right after
temp of water
some say cold between 40-50 degrees F
some say room temp 85-90 degrees F
what is a common side effect of a BE
a spasm
can be caused by pt. anxiety, discomfort etc.
what my be added to the contrast to minimize spasm
lidocaine
if spasm occurs during procedure what can be given intravenously
glucagon
pt is placed in what position before enema tip is inserted
sims position
what does sim’s position do
relaxes abdominal muscles and decreases pressure
enema tip insertion
elevate right buttock laterally
tell pt. relax take deep breaths
tip inserted on expiration
how should the tip be directed
1-1and1/2 inches aimed toward umbilicus then follow the curve of the rectum slightly superior
the total insertion of the tip should not exceed
4 inches (10cm)
the enema contents should be NO HIGHER than
24 inches (60 cm) above the xray table
list of lower GI procedures
- single contrast BE
- double contrast BE
- evacuative proctography (defecography)
single contrast BE
positive contrast only barium fills large intestine rectum fills slowly when exam is done bag is lowered so barium flows back into bag pt. sent to bathroom postevac radiograph is taken
most commonly obtained projections for a single contrast BE
scout PA or AP PA or PA oblique axial lateral post evac AP or PA
double contrast barium enema
more effective for demonstrating polyps and diverticula
air and barium introduced into large intestine
evacuative proctograpy purpose
functional study of anus and rectum that is conducted during the evacuation and rest phases of defecation
T or F
no pt. prep necessary for defacography
TRUE
defacography pathologic indications
rectocele
rectal intussusception
rectal prolapse
rectocele
blind pouch of rectum caused by weakening of anterior or posterior wall
rectal intussusception
telescoping or invagination of the rectal portion of the bowel
rectal prolapse
protrusion of rectal tissue through the anus to the exterior of the body
do you need very high density barium sulfate for defacography
yes
some departments mix barium with potato starch
applicator for defacography
resembles a caulking gun
anatrast is the contrast put into the gun
flexible enema tip attatched
defacography procedure
pt. in a lateral recumbant position on the cart
contrast media put into rectum
small BB placed at the anal orifice
pt. put on the commode for filming during defecation
a lateral recumbant post evac radiograph is taken
anorectal angle
alignment between the anus and rectum that shifts between the rest and evacuation phases
radiologist measures the anorectal angle during rest and evacuation phases to determine whether any abnormalities exist
TRUE
colostomy
an incision into the colon to create an artificial opening to the exterior of the abdomen
serves as a substitute anus
clinical indications for a colostomy barium enema
to asses for proper healing, obstruction or leakage, or to perform presurgical evaluation
