GI Fluoroscopy

Question 1

what is fluoroscopy?

Answer 1

*a series of x-rays after administration of contrast
*performed by a radiologist, not a technologist
*dynamic - we see how the contrast moves over time

Question 2

single contrast in GI fluoroscopy

Answer 2

*barium or water soluble
*for distensibility, motility, or leak

Question 3

double contrast in GI fluoroscopy

Answer 3

*barium and air
*for mucosal detail

Question 4

barium contrast

Answer 4

*coats mucosal surfaces well
*contraindicated if leak or bowel obstruction

Question 5

water soluble contrast

Answer 5

*iodine based (watch for allergies)
*great for leaks

Question 6

modified barium swallow

Answer 6

*performed with speech pathologist
*looks for aspiration
*patient swallows different consistencies of barium
*determines diet recommendations (determines what patients can safely eat without aspiration)

Question 7

esophagram

Answer 7

*images pharynx and esophagus
*double contrast exam is excellent for DYSPHAGIA
*water-soluble to check for leaks

Question 8

upper GI fluoroscopy

Answer 8

*images esophagus, stomach, and duodenum
*good for epigastric pain if suspected gastric or duodenal etiology (can see masses, strictures, hiatal hernias, reflux, gastritis, ulcers)
*good for surgical problem solving (check anastomotic patency, leaks)

Question 9

small bowel follow through (fluoroscopy)

Answer 9

*single contrast, usually with barium
*mostly been replaced by CT enterography and MR enterography
*for strictures, fistulas, masses, and adhesions
*assesses small bowel transit time

Question 10

bedside small bowel follow through

Answer 10

*for inpatients with suspected adhesive small bowel obstructions
*helps determine surgical vs non-surgical management

Question 11

double contrast barium enema

Answer 11

*screening exam for colon cancer
*replaced by colonoscopy and virtual colonography, which are more sensitive tests

Question 12

single contrast enema

Answer 12

*evaluates for stricture, fistula, leak, or volvulus
*great for surgical problem solving

Question 13

enteric tubes

Answer 13

*difficult feeding tubes can be placed under fluoroscopy (good option if failed prior attempt)
*uses radiation (so not first choice)

Question 14

modified barium swallow - common indications & anatomy visualized

Answer 14

*common indications: aspiration
*anatomy visualized: pharynx

Question 15

esophagram - common indications & anatomy visualized

Answer 15

*common indications: dysphagia, leaks
*anatomy visualized: pharynx, esophagus

Question 16

upper GI study - common indications & anatomy visualized

Answer 16

*common indications: epigastric pain, hiatal hernia, reflux, strictures, masses, leaks
*anatomy visualized: esophagus, stomach, duodenum

Question 17

small bowel follow through - common indications & anatomy visualized

Answer 17

*common indications: strictures, fistulas, masses, adhesions, transit time
*anatomy visualized: duodenum, jejunum, ileum

Question 18

bedside small bowel follow through - common indications & anatomy visualized

Answer 18

*common indications: adhesive small bowel obstruction management
*anatomy visualized: small bowel, colon (variable)

Question 19

enema - common indications & anatomy visualized

Answer 19

*common indications: colon cancer screening (rarely), stricture, fistula, leak, colonic volvulus
*anatomy visualized: colon

Question 20

enteric tube placement - common indications & anatomy visualized

Answer 20

*common indications: failed tube placement
*anatomy visualized: varies; placed gastric or post-pyloric