Upper GI Imaging Flashcards
Contrast media and adjunct drugs
- barium sulphate
- Gastrografin
- Carbex granules
- Buscopan
- Maxalon
Barium sulphate
- needs to be fluidic as it is being swallowed and have some viscosity to coat mucosa
- needs to be flavoured
Gastrografin (iodinated water soluble contrast )
- needs to be flavoured
- Used for paeds and suspected perforations and when barium sulphate is contraindicated
Carbex granules and solution (CO2)
- needed to produce gas in the stomach - for double contrast
Buscopan
smooth muscle relaxant that stops bowel cramps and movement to improve image quality
Maxalon - (Metoclopramide)- oral solution
Antiemetic - speeds up bowel transit times - used if bowel transit is slow in patients baFT (barium follow through)
Barium Swallow
- To image the pharynx, oesophagus and proximal section of the stomach.
- uses a contrast agent to coat and outline the structures
- used in fluoroscopy
- can use barium or water-soluble contrast according to patient presentation
Barium swallow indications
- Dysphagia
- Globus sensation
- motility issues
- anaemia
- Assessment of fistulae
- Failed upper GI endoscopy
- Barrret’s Oesophagus
Barium swallow complications
- leakage of barium from unknown perforation
- Aspiration
- barium appendicitis (rare)
- obstruction
Barium swallow
……
why is a barium swallow used?
- it demonstrates the presence of an abnormality
- Look at the initiation of deglutition to the clearance of barium from the
hypopharynx
• Image the distended oesophagus, gastro-oesophageal junction and
gastric fundus
• Is the motility normal?
Fluoroscopy unit needs to be capable of:
- imaging at greater than 6fps
- video recording
- grab loops of fluoroscopy screening
- tilting
Barium swallow patient prep
- patient is NBM
- remove any artefacts - patient changes from waist upwards into gown.
- Explanation/reassurance throughout
- ID patient
- verbal consent
- warn patient about moving equipment and tilting table
- Handles for patient stability
- Patient may sit on step / chair
- Pillow for supine / prone views
- Assistance with drink/cup
Barium swallow technique
- table is tilted
- patient stands on the step
- RAO to start (oesophagus clear of spine)
- patient holds cup in left hand
- patient is asked to swallow a mouthful - dynamics are observed
- further swallows to record entire oesophagus
- Dynamic coned views of hypopharynx AP & lateral
barium swallow: LPO