Systems-Small bowel series Flashcards
What quadrent is the duodenum in?
The right and left upper quadrent
What quadrent is the illiocecal valve in?
RLQ
What quadrents is the jejunum in?
LUQ, LLQ
What quadrents is the illeum in?
RUQ, RLQ, LLQ
What is the order of the small intestine parts?
Duodenum, jejunum, illeum
What are 3 examples of indications for small bowel imaging?
Pain
Bleeding
Enteritis
What is Enteritis
Inflammtion of the small bowels
What are the 2 methods of adminstering contrast for small bowel imaging?
- By mouth
- Enteroclysis
Where is contrast injectedd when contrast is administered through the enteroclysis method?
Direct injection of contrast into the bowel through an intestinal tube
What is another name for the enteroclysis method?
Small intestine enema
T/F
For imaging of the small bowel, you should always include pubic symphysis
True
What are the contraindications to small bowel imaging?
- Complete obstruction
- Suspected perforation
- Pre-surgical patients;
- Concern regarding fecal impaction
What is the patient prep prior to small bowel imaging for the UGI or SBFT proceedures?
- Low residue diet 2-3 days prior to exam
- NPO 8-12 hours before the exam
- No smoking or chewing gum
- Remove all clothing, put on hospital gown
- Possible cleansing enema before
If there was a perforation or obstruction, and the patient needed small bowel imaging, what type of contrast would we give them?
Water-soluble iodinated contrast
What percentage of barium sulfate is given for the small bowel series imaging?
30%-50% w/v
What can be done if the patient’s peristalsis is very slow in small bowel imaging?
-Have them move around between images
-Give them gastric stimulants
T/F
You can give negative contrast for the small bowel series when requested.
True
What is the proceedure step by step for the Upper GI & SBFT Combination proceedure?
- Optional scout w/o contrast
- Routine UGI
- Ingest second amount of barium
- 1st image taken immediately following ingestion or at 15 minutes – PA/AP abdomen
- 30-minute image – PA/AP abdomen
What is the centering point for the UGI and the SBFT Combination?
Centered at (L2) for stomach and proximal Small Bowel
For the oral method SBFT, how often are images taken?
Every 30 minutes until barium reaches the terminal ileum (usually 2 hours)
What does SBFT stand for?
Small bowel follow-through
What are the three views for the Upper GI & SBFT Combination?
- Prone
- Supine
- LPO
What is the purpose of doing prone imaging for the Upper GI & SBFT Combination proceedure?
-Compress the abdominal contents
-Provides radiation protection,
What is the pupose of doing supine imaging for the Upper GI & SBFT Combination proceedure?
-Prevents compression of overlapping loops of intestine
What does supine imaging demonstrate for the Upper GI & SBFT Combination proceedure?
Demonstrates superior and lateral shift of barium-filled stomach
How much should the patient be obliqued for the LPO imaging for the Upper GI & SBFT Combination proceedure?
Oblique view to demo the stomach and 1st part of duodenum
What is the the centering point for images taken up to 15 minutes after contrast injection for the Upper GI & SBFT Combination proceedure?
L2
What is the the centering point for images taken after 15 minutes after contrast injection for the Upper GI & SBFT Combination proceedure?
At the illiac crest
What kVp is used for the Upper GI & SBFT Combination proceedure?
125kVp
What body position is used for imaging of the Upper GI & SBFT Combination proceedure? Why?
Trendelenburg – to unfold low-lying and superimposed bowel loops of ileum
What modality is used for the Upper GI & SBFT Combination proceedure?
Floro
T/F
Compression is used for upper GI & SBFT Combination proceedures.
True
What type of marker must be present in Upper GI & SBFT Combination proceedures?
Time markers
Label 1-4
- Cecum
- Illeocecal valve
- Ascending colon
- Illeum
What should be seen on a SBFT
- Entire intestine on each image
- Stomach on initial image (centering at L2)
- Time markers
- No rotation
What is this?
A compression paddle
What is the benefit of the compression paddle in SBFT proceedures?
Lets us see the ileocecal valve without superimposition
What is this?
A compression device
What are the post care instructions for UGI and SBFT combination proceedures?
- Patient is encouraged to drink plenty of liquids
- Resume normal diet
- Warn about possible white bowel movements
When is Enteroclysis used?
Used when oral method fails to provide conclusive information
What type of tube is used for Enteroclysis proceedures?
A Small bowel enema tube- using an NG, Bilbao-Dotter or Sellink tube
Where is the small bowel enema tube used for Enteroclysis proceedures passed to?
Passed to the Duodenojejunal flexure - near ligament of Treitz
What tube is being shown here?
Bilbao-Dotter tube used for Enteroclysis proceedures
Are Enteroclysis proceedures done with single or double contrast?
Double contrast
T/F
You can use compression for enteroclysis proceedures.
True
At what speed does the barium run at for enteroclysis proceedures until it reaches the cecum?
100 ml/min
Watch video
https://www.youtube.com/watch?v=49JrzZM2MX8
