Chpt. 13 Situations

Question 1

double-contrast BE XR shows obscured anatomic side marker. the tech is unsure whether it is PA/AP recumbent. the transverse colon is primarily filled w Ba, w ascending and descending colon containing lesser amount. which pos?

Answer 1

PA (transverse colon is intraperitoneal aspect of lg intestine and more ant.)

Question 2

lat decub XR taken during air-contrast BE shows upside aspect of colon over-penetrated using analog at 120 kV, 30 mAs, 40” SID, and compensating filter for air-filled aspect of lg intestine. what must be corrected?

Answer 2

less kV required bc of air-contrast (should use 90-100 kV)

Question 3

AP axial BE XR of rectosigmoid region shows there is considerable superimposition of the sigmoid colon and rectum using analog at 120 kV, 20 mAs, 40” SID, 35º caudad CR and collimation. what must be corrected?

Answer 3

CR wrong direction (should be 30-40º cephalic)

Question 4

BE on hypersthenic pt shows that majority of XRs show that the L colic flexure was cut off. what can be done on repeat?

Answer 4

use (2) 14x17” CW IR’s for AP/PA and obl XRs, one centered higher

Question 5

a tech has inserted an air-contrast retention tip for a double-contrast study. he’s not sure how much to inflate the balloon. should he inflate as much as pt can tolerate or is there a better way?

Answer 5

retention catheters should be inflated only by radiologist under fluoro guidance

Question 6

describe Sim’s pos for rectal tip insertion for BE

Answer 6

lay on L side and flex head and upper body forward, drawing the R leg up above partially flexed L leg

Question 7

pt w clinical history of regional enteritis comes to rad dept. what type of procedure would be most diagnostic for this condition?

Answer 7

enteroclysis, a double-contrast SBS. A routine SBFT can also show this but not as effective at showing mucosal changes; CT enteroclysis can provide further analysis

Question 8

pt comes in for a pre surgical SBS. what modifications to standard SBS must be made?

Answer 8

h20-soluble, iodinated contrast should be used

Question 9

pt comes in for SBS, but cannot swallow contrast. what type of study should be done for this pt?

Answer 9

diagnostic intubation SBS preferred. An NG tube passed into sm intestine so contrast instilled

Question 10

infant w possible intussusception brought to ER. what XR procedure may serve therapeutic role in correcting this condition?

Answer 10

BE or air-contrast BE often leads to re-expansion of telescoped aspect of the lg intestine

Question 11

before BE, the tech experienced difficulty in inserting rectal tip (w/o causing significant pn to pt). what should tech do to complete task?

Answer 11

inform radiologist and have them insert it under fluoro

Question 12

during the fluoro aspect of BE, the radiologist detects an unusual defect w/in the R colic flexure. she asks tech to provide the best img’s possible of this region. which 2 XR’s will best show the R colic flexure?

Answer 12

RAO/LPO

Question 13

pt w clinical history of possible enteritis comes in. which type of GI study would most likely be indicated for this condition?

Answer 13

SBFT (enteritis is an inflammation/infection of sm intestine)

Question 14

pt’s clinical history includes possible giardiasis. what procedures would likely be indicated for this condition?

Answer 14

SBFT (giardiasis is an inflammation/infection of sm intestine)

Question 15

pt is scheduled for CTC. what is recommended pt prep for this procedure?

Answer 15

pt should have cleansing bowel prep. the am of the exam; food intake limited to clear liquids; pt should wear loose-fitting clothes w/o metal