EGJ

Question 1

EGJ Indication

Answer 1

Hiatal Hernia/ Diaphragmatic Hernia

Question 2

2 Types of Hiatal Hernia

Answer 2

1. Sliding
2. Fixed

Question 3

EGJ Respiratory Maneuveral Requirement

Answer 3

1. Valsalva
2. Modified Valsava
3. Mueller method: exhale deeply and forcibly w nose and mouth closed

Question 4

EGJ Techniques

Answer 4

1. Wold technique
2. Water siphonage technique
3. Toe-touch techique
4. Sommer-Foegelle Technique

Question 5

Obj: Greater intra-abdominal pressure than is provided by Ba alone

Answer 5

Wolf technique

Question 6

Ensures more consistent result in demonstrating sliding type

Answer 6

Wolf technique

Question 7

Most common procedure nowadays for hiatal Hernia/ Diaphragmatic hernia

Answer 7

Wolf technique

Question 8

Requires use of semi0cylindrical radiolucent compression device measuring 22” (55cm) in length, 10” (24cm) in width, and 8” (20cm) in height

Answer 8

Wolf technique

Question 9

Prone; inflatable cushion under gastric area while pt- knee- chest posn

Answer 9

Wolf technique

Question 10

Compression device horizontally under abdomen and just below costal amrgin

Answer 10

Wolf technique

Question 11

40-45deg Rao posn w thorax centered to the midline of the grid

Answer 11

Wolf technique

Question 12

Instruct pt tot ingest ba suspension in rapid, continuous swallows

Answer 12

Wolf technique

Question 13

Purpose of making the exposure during 3rd/ 4th swallow during Wolf technique

Answer 13

To allow for complete filling of esophagus

Question 14

Wolf technique cxt and crd

Answer 14

14x17- Perp- LA- pt’s back and centered- level- either T6 or T7

This posn usually results in a 10-20deg caudal cr angulation

Question 15

Wolf and Guglielmo stated that the compression device not only provides (1) but also (2) enough to permit adequate contrast filling and maximum distention of entire esophagus.

Answer 15

1. Trendelenburg andulationg of pt trunk
2. increases intra abdominal pressure

Question 16

Doesn’t require table angulation, thus, pt is able to hold ba container and ingest ba suspension through a straw w comparative ease

Answer 16

Wolf technique

Question 17

Pt swallow ba suspension thru glass w/ siphon

Answer 17

Water siphonage technique

Question 18

PA, RPO, Lat, LPO, and Trendelenburg (head end 25-30deg lowered)- Valsalva maneuver

Answer 18

Water siphonage technique

Question 19

Pt- front- vertically positioned RT- left lat- toe touch to bend ba suspension swallowed and exposure made

Answer 19

Toe-touch technique

Question 20

CRD (H)- T12 (level of esophagogastric sphincter)

Answer 20

Toe-touch technique

Question 21

Pt- prone top- 34deg cranial angle board at gastric area

Answer 21

Sommer Foegelle Technique

Question 22

Sommer Foegelle Technique IR

Answer 22

10x12- top- 34deg cranial- angle board- MP