small intestine

Question 1

– pouch creates by the herniation of the mucous membrane through the muscular coat

Answer 1

diverticulum

Question 2

– prolapsed of a portion of the bowel into the lumen of an adjacent part

Answer 2

inussusception

Question 3

malabsorption disease caused by a mucosal defect in the jejunum

Answer 3

celiac disease or sprue

Question 4

diverticulum of the distal ileum, similar to appendix

Answer 4

meckel’s diverticulum

Question 5

inflammation of the terminal portion of the ileum

Answer 5

Regional enteritis or Crohn’

Question 6

twisting of a bowel loop upon itself

Answer 6

volvulus

Question 7

rare disorder of the proximal bowel whose cause is unknown

Answer 7

whipple’s disease

Question 8

method

Answer 8

• Mouth
• reflux filling with large-volume
  barium enema
• direct injection into the bowel
  through an intestinal tube >
  enteroclysis or small intestine
  enema
  ❖ Done if oral method fails to
  provide conclusive information

Question 9

PREPARATION FOR EXAMINATION:

Answer 9

• soft or low-residue diet for 2 days
• food & fluid w/ held after the evening meal of the day before examination > breakfast w/held on the day of the study
• cleansing enema > not recommended for enteroclysis – because enema fluid may be retained in the small intestine
• bladder should be empty before & during the procedure - to avoid displacing or compressing the ileum

Question 10

– take advantage of the superior & lateral shift of barium-filled stomach for visualization of duodenum & jejunum
- prevent possible compression overlapping of loops of intestine

Answer 10

SUPINE

Question 11

cholinergic drug (20mg metoclopramide)
* increase peristalsis
* given prior to ingestion of barium meal
* reduces transit time to about 1/3
* valuable for evaluation of stomach when gastric *atony or **pylorospasm is present
(atony – lack of muscle tone *pylorospasm - severe spasm of the sphincter muscle of the pylorus causing pain in the upper abdomen)

Answer 11

Howarth et al Technique

Question 12

10ml Gastrografin + barium sulfate
* accelerate peristalsis
* head of the barium mixture reaches the cecum w/in 45 mins.

Answer 12

Goldtein et al

Question 13

• Before the examination, glucagon may be administered to relax the intestine.
• Diazepam (Valium) may also be given to diminish patient discomfort during the initial filling of the bowel.
  o A 15% ± 5% weight/volume barium suspension is often used, and a large amount of the suspension (about 4500
  ml) is required to fill the colon and small intestine.
• A retention enema tip is used, and the patient is placed in the supine position for the examination.
• The barium suspension is allowed to flow until it is observed in the duodenal bulb.
• The enema bag is then lowered to the floor to drain the colon before radiographs of the small intestine are obtained

Answer 13

Complete Reflux
Examination

Question 14

• the injection of nutrient or medicinal liquid into the bowel
• is a radiographic procedure in which contrast medium is injected into the duodenum under fluoroscopic control for examination of the small intestine.
• the contrast medium is injected through a Bilbao or Sel link tube

Answer 14

enteroclysis

Question 15

• procedure in w/c a long, specifically designed tube is inserted through the nose & passed into the stomach (NGT)
• used for both therapeutic & diagnostic purposes
  o therapeutic – tube (Miller Abbott –MA tube) is connected to a suction system for continuous siphoning of the gas & filled content of the GIT
  o purpose: to prevent or relieve postoperative distention or to deflate or decompress an obstructed small intestine
• CM introduced through the tube in a continuous, low-pressure flow
• spot & conventional radiographs taken as indicated

Answer 15

Intubation Examination Procedure (AP)