SIS/ Small Bowel Series Flashcards
Being in supine during SIS takes advantage of the (1) to vizualize the (2), to prevent compression of overlapping loops of intestine
- superior and lat shift of Ba-filled stomach
- retrogastic part of duodenum and jejenum
Prevents compression of overlapping loops of intestine
Being in supine during small bowel series
SIS is aka
Small bowel series
Asthenic pt’s are placed in (1) during SIS to unfold (2)
- trendeleburg
- low-lying superimposed loops of ileum
SIS Indications
- diverticulum
- intussusception
- intestinal fistula
- parasitism
- polyps
- tumor
TIP DIP
SIS Methods
- Oral
- Reflux
- Intubation/ Enteroclysis
Ingestion of CM until it reaches the ceccal part of LI
SIS Oral Method
Usually taken 15mins after ingestion: interval of 15-30mins for the next exposure and finishes 30-60mins depending on the condition
SIS Oral Method
2L barium given to pt thru glass
SIS Oral Method
NSS/ Cold ice water given to increase persialsis, or coffee. tea for hypomotile stomachs
SIS Oral Method
SIS Oral Method
Coffee/tea for (1); NSS/ Cold ice water for (2)
- hypomotile stomachs
- increased peristalsis
When is reflux method for SIS done?
Done when oral exam can’t be made; CM given rectally
Complete — exam’n: utilization of enema set
reflux (hypotonic duodenograpy)
Drugs given during SIS reflux method
2mg glucagon
1 mg atropine
valium
Prevents sudden dripping of glucose
Glucagon (2mg)
Gives atony effect on LI so that CM does not easily goes out of the rectum
Atropine (1mg)
Relaxes pt (LI should be filled before the SI thus pressure from Abdomen is high; pt may not be able to tolerate)
Valium
15% ba suspension (4500ml to fill entire colon)
SIS Reflux Method
Same w/ BaE; CM is allowed to flow until duodenal bulb then enema bag is lowered down to drain colon, and radiographs are taken
SIS Reflux Method
Purpose of lowering down the enema bag in SIS reflux method
to drain colon
Enteroclysis
SIS tube is advance until —
prox loop of jejenum (duodenojejunal flexure near the ligament of treitz)
ba or 100ml/min is introduced
SIS Intubation Method/ Enteroclysis
Air/ methyl cellulose is sometimes given after ba introduction reaching the cecum for double contrast study
SIS Intubation Method/ Enteroclysis
SIS Phases of Study + descroption
- Distention phase: filling of SI
- Post-distention phase: CM has reached the LI (ascending colon)
SIS RP
L2/ iliac crest for delayed radiographs
UB must be empty
SIS Scout film of abdomen
SIS Scout film of abdomen take lateral in case of —
mass shadow
Taken after 30mins of CM ingestion
SIS Distention Phase (Oral Method)
Termination point is when ba reached ileu-ceccal
SIS Distention Phase (Oral Method)
Start filming when ba reaches duodenal bulb
SIS Distention Phase (Reflux Method)
SIS Intubation Phase (Enteroclysis)f
- AP Rec (as it is with oral and reflux method, as well as Scout film of abdomen and enteroclysis)
- Lat decub: when there is suspected tumor
