Systems-Large Bowel BE Flashcards
What are the two types of contrast that can be used for large bowel images?
- Single contrast using barium only
- Double contrast using barium and room air/carbon dioxide
T/F
For large bowel imaging, double contrast is used more often.
True
Why is using CO2 better than just using regular air for GI imaging?
Carbon dioxide is more rapidly absorbed compared to the nitrogen in room air which produces less cramping
What are 3 examples of clinical indications for large bowel imaging?
- Change in bowel habits
- Abdominal pain
- Palpable Mass
What pathology is being shown here?
Apple core lesion
What pathology is being shown here?
Diverticulitus
What are the contraindications to barium?
- Suspected perforation/bowel obstruction
- Immediately prior to surgery
- Bowel biopsy in past 24hrs
- Recent pelvic irradiation
- Poor bowel preparations
T/F
It is essential that the bowel be completely cleansed of stool for large bowel imaging. Why or why not?
True; Retained ‘stool’ can resemble polyps or obstruct visualization of anatomy or pathology and prevents the barium from sticking to the bowel wall
What is the first image done for bowel imaging?
Scout images
What are the arrows pointing to?
Arrows pointing to residual stool mimicking pathology
What patient prep needs to be done prior to imaging for the large bowel series?
- Low residue diet 3 days prior
- Fluids only 24 hrs prior
- Laxative day before –
- Possible suppository or cleansing enema the morning of the exam
- Remove all clothing - hospital gown
What patient prep is done for infants for the large bowel series?
None
What are the contraindications to laxatives/cathartics?
- Gross bleeding
- Severe diarrhea
- Known obstruction
- Inflammatory conditions (appendicitis)
T/F
Patients with diabetes require special instructions from thier physicians for pre medications.
True
When are anticholinergic drugs adminsitered in large bowel imaging? What is it’s purpose?
-Administered intravenously before enema
-Administered to reduce motility, relieve spasm and allow bowel to expand for images
What are the contraindications to recieving anticholinergic drugs?
Cardiac disease, glaucoma
What should the tempeture of the varium be for large bowel imaging?
-Cold or warm
-Never hot
What are the benefits of cold barium?
- less irritation
- Has a mild anesthetic effect – relaxes colon
- Stimulates tonic contraction of the anal sphincter making it easier to retain
What are the benefits of warm barium?
Maximum patient comfort
What is the most common type of enema tube?
Double lumen tub
If a patient has an abnormal anus, what enema tube should you use?
A Foley catheter
What are the pathologies that require a foley catheter?
- Severe hemorrhoids
- Fissures
- Stricture
What does A and B inflate?
A=Air into the rectum
B=Inflates the balloon
What is this?
A CO2 machine for double contrast
Read over the steps of the large bowel imaging proceedure:
Slide 26
What body position should the patient be placed in for large bowel imaging?
Sims position
How should the enema tube be inserted into the patients anus?
- On expiration, direct enema tip anteriorly toward the umbilicus approximately 1 to 1 ½ “
- Advance tip superiorly. The total insertion should not exceed 4” or 10 cm.
How should the IV pole/enema bag be above the table?
No more than 24 inches (60 cm) above the table
Is this the initial insertment or final placement?
Initial insertment
T/F
The benefit of putting the patient in the sims position is that it reduces abdominal pressure and relaxes abdominal muscles.
True
What are the two methods for imaging the large bowel?
- Single contrast
- Double contrast
What does using single contrast for the large bowel demonstrate?
Demonstrates general anatomy of colon and tonus (muscle definition)
T/F
For single contrast studies, thinner barium is used
True