SIS Flashcards
Radiographic examination specifically of the small intestine?
Small Intestinal Series (SIS) or Small Bowel Series
Upper GI and small bowel are frequently combined.
Small Intestinal Series (SIS) or Small Bowel Series
What is the required Contrast Media?
- 2 cups (16oz) of BaSO4 only and 1 cup (8oz) for small bowel follow through
- Thin mixture of BaS04
What is the purpose of SIS?
- to study from and function of the 3 components of the small bowel and to detect any abnormal conditions
What are the indications?
- To demonstrate fitsula
- To demonstrate diverticula/diverticulum
- Mechanical obstruction
- Functional obstruction - To demonstrate obstruction
- To demonstrate polyps or small tumor
- To demonstrate perforation (an opening)
- To demonstrate neoplasm (a tumor)
- To demonstrate peptic ulcer
- To demonstrate enteritis
- To demonstrate regional enteritis or Crohn’s disease
What are the contra-indications?
- Bowel perforation
- Patient with large bowel obstruction.
What are the preparation for examination?
- Ideally, the patient should be on a low-residue be on a low-residue diet 48 hours before the small bowel series is conducted
- Food and fluid must be withheld for at least 8 hours before the examination is performed
- In addition, the patient should not use any type of tobacco or nicotine products or chew gum during the NPO period
- Breakfast is withheld on the day of the study
- A cleaning enema may be administered to clear the colon; however, an enema is not always recommended for enteroclysis because enema fluid mat be retained in the small intestine
- Before the procedure is performed, the patient should be asked to void, so as not to cause displacement of the ileum secondary to a distented bladder
What are the 4 methods used to study the small intestine radiographically?
- UGI-Small bowel combination
- Small bowel only series
- Enteroclysis
- Intubation method
- third method of small bowel study which is a double contrast method
- injection of a nutrient or medicinal liquid into the bowel
Enteroclysis (Double-Contrast small bowel series)
What are the procedures of Enteroclysis?
- special catheter (enteroclysis catheter) advanced to duodenojejunal junction
- thin mixture of barium sulfate instilled - air or methylcellulose instilled
- fluroscopic spot images and conventional radiographs taken
What are the indication of Enteroclysis?
Patients with clinical histories of:
1. small bowel ileus
2. regional enteritis (Crohn’s Disease)
3. malabsorption syndrome
What are the disadvantages?
- increased patient discomfort
- possibility of bowel perforation during catheter placement
- may be referred to as a small bowel enema
- A single-lumen tube is passed into the proximal jejunum
- the patient is placed into an RAO position that may aid in passage of the tube from the stomach into the duodenum by gastric peristaltic action
- A watersoluble iodinated agent or a thin barium sulfate
suspension is injected through the tube - Radiographs are taken at timed intervals similar to in a
standard small bowel series
Diagnostic Intubation
- sometimes referred to as a small bowel enema
- With this technique, a nasogastric tube is passed through the patient’s nose, through the esophagus, stomach, and duodenum, and into the jejunum
- This procedure is performed for both diagnostic and
therapeutic purposes.
Intubation method (Single contrast study)
- performed often to relieve postoperative distention or to decompress a small bowel obstruction
- Miller-Abbott (M-A) tube, a double-lumen catheter, is
advanced into the stomach - Radiopaque materials often are incorporated into the
design of the catheter to assist during fluoroscopy-guided placement - Through peristalsis, the catheter is advanced into the
jejunum - The technologist may be asked to take radiographs at
timed intervals to determine whether the catheter is
advancing - Gas and excessive fluids can be withdrawn through the
catheter.
Therapeutic Intubation
